Radical surgery remains the cornerstone of treatment for early non-small cell lung cancer, but disappointing long-term results suggest that an alternative strategy is needed (ie, a combined modality approach). Data from randomized clinical trials testing different postoperative strategies have failed to show survival benefits. Promising data with preoperative chemotherapy using platinum-based regimens in early non-small cell lung cancer make this approach a priority for study in ongoing clinical trials. Current trials investigating the efficacy of neoadjuvant chemotherapy in patients with resectable non-small cell lung cancer, including the Chemotherapy for Early Stages Trial comparing preoperative gemcitabine/cisplatin plus surgery versus surgery alone, will eventually include more than 3,000 total patients.