Systemic therapy for lung cancer has long been an area of therapeutic nihilism. The toxicity of the treatment was high, and the potential benefits were considered to be minimal. In the last decade, clinicians have increased the proportion of lung cancer patients to whom they offer systemic therapy. Novel combinations of third-generation agents have demonstrated better efficacy with response rates of ≥ 30%, better tolerability, and, now, evidence to support second-line and even third-line systemic treatment (ie, docetaxel or pemetrexed, then erlotinib) to prolong survival and to improve symptoms and quality of life in patients with advanced NSCLC. Prior studies, including the IALT,8 included older chemotherapy combinations, with potentially higher toxicity, less patient compliance, and lesser efficacy than presently used novel combinations. For example, regimens containing alkylating agents were associated with decreased survival time when administered in the adjuvant setting. Thus, while the IALT8 confirms the modest benefits seen in the metaanalysis of adjuvant chemotherapy and is statistically significant, most patients received an older combination regimen (ie, etoposide and cisplatin). The results of the NCIC-CTG BR10 trial,10 and CALBG 9633 trial9 are important as they are the first trials of third-generation platinum-based combination therapies to be reported, and both demonstrate a significant survival benefit when these newer agents, which are accepted as standard regimens around the world in patients with advanced disease, are administered in the adjuvant setting.