The importance of evaluating the impact of any therapy on the quality of life (QOL) of patients with malignancy has been demonstrated in recent literature (29). Patients with advanced NSCLC suffer from a variety of treatment related challenges and do not have an expectation of cure. Hence, it is particularly important to compare treatment alternatives not only on survival endpoints but also on QOL. Therefore, we propose to incorporate QOL evaluations in the proposed clinical trial. QOL instrument we are using is the FACT-L (version 4). The FACT-L is a validated 36-item Likert instrument that combines both relative frequency of symptomatic/quality of life problems with the patients perceived relative importance of each issue (30).