Patient accrual will continue for Lung Cancer Study Group (LCSG) adjuvant studies in resectable and partially resectable non-small cell lung cancer. There are six active LCSG adjuvant protocols: LCSG 772 for Stage II-III adenocarcinoma and undifferentiated lung tumors compares combination chemotherapy with CAP (Cytoxan, Adriamycin, cis-Platinum) vs Intrapleural BCG (IPBCG) + INH plus Lavamisole; LCSG 773 for Stage II-III squamous cell evaluates postoperative XRT; LCSG 791 for resected patients with micropscopic and macroscopic residual disease compares CAP vs CAP plus XRT; LCSG 801 for T1N1, T2N0 evaluates CAP following resection. A recently activated protocol, LCSG 821, randomizes patients preoperatively to a tissue-preserving limited resection (wedge or segmental) or to a standard lobectomy. Eligible patients, who are not entered into this protocol for some reason, will continue to be registered into the Natural History Catalogue. Follow-up and data collection will continue for the inactive LCSG protocol for Stage I resected non-small cell lung disease evaluating intrapleural BCG plus INH vs placebo. Our experience indicates that we should be able to randomize 30-35 patients per year into these studies. To date, we have accrued a total of 148 patients generated from the UCLA Center for the Health Sciences, two UCLA-affiliated VA hospitals - Wadsworth and Sepulveda, and St. Joseph Hospital in Orange, CA. Another institution may become a source of patients in the future. We will continue our pilot study evaluating direct intralesional BCG injection and studies of lymphocytes infiltrating injected and non-injected tumors. New protocols are being developed. One will evaluate preoperative chemotherapy; another will evaluate radiation therapy in patients with chest wall resection. In the future, the role of surgery in patients with small cell carcinoma will be examined. We plan, as well, to address the issue of quality of life of the patient in all of the various studies.
