Chemotherapy beyond first-line in stage IV metastatic non-small cell lung cancer

Younes, Riad Naim; Pereira, José Rodrígues; Fares, Abdo Latif; Gross, Jefferson Luiz

doi:10.1590/s0104-42302011000600017

Cited by 21 publications

(21 citation statements)

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“…There were 2 studies that included only patients with a single NSCLC histology—one with only squamous patients, and one with only non-squamous patients [26, 27]. Among the other studies, adenocarcinoma was the most common NSCLC histology, with the proportion of adenocarcinoma patients ranging from 33% in Brazil to 77% in Japan [13, 23]. Two studies enrolled only stage IV patients [20, 23].…”

Section: Resultsmentioning

confidence: 99%

“…Among the other studies, adenocarcinoma was the most common NSCLC histology, with the proportion of adenocarcinoma patients ranging from 33% in Brazil to 77% in Japan [13, 23]. Two studies enrolled only stage IV patients [20, 23]. The proportion of patients who never smoked was highest in the Japanese cohort [13,].…”

Section: Resultsmentioning

confidence: 99%

“…The top 3 anti-cancer treatment regimens in the fourth-line setting were single-agent S-1 (22%), docetaxel (21%), and gefitinib (21%) [13]. In Brazil, 2.5% of all patients with stage IV NSCLC (4.3% of the patients who received first-line chemotherapy) received fourth-line chemotherapy [23]. …”

Section: Resultsmentioning

confidence: 99%

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Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: A systematic review of recently published studies

et al. 2017

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Most patients with advanced non-small cell lung cancer (NSCLC) have a poor prognosis and receive limited benefit from conventional treatments, especially in later lines of therapy. In recent years, several novel therapies have been approved for second- and third-line treatment of advanced NSCLC. In light of these approvals, it is valuable to understand the uptake of these new treatments in routine clinical practice and their impact on patient care. A systematic literature search was conducted in multiple scientific databases to identify observational cohort studies published between January 2010 and March 2017 that described second- or third-line treatment patterns and clinical outcomes in patients with advanced NSCLC. A qualitative data synthesis was performed because a meta-analysis was not possible due to the heterogeneity of the study populations. A total of 12 different study cohorts in 15 articles were identified. In these cohorts, single-agent chemotherapy was the most commonly administered treatment in both the second- and third-line settings. In the 5 studies that described survival from the time of second-line treatment initiation, median overall survival ranged from 4.6 months (95% CI, 3.8–5.7) to 12.8 months (95% CI, 10.7–14.5). There was limited information on the use of biomarker-directed therapy in these patient populations. This systematic literature review offers insights into the adoption of novel therapies into routine clinical practice for second- and third-line treatment of patients with advanced NSCLC. This information provides a valuable real-world context for the impact of recently approved treatments for advanced NSCLC.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: A systematic review of recently published studies

et al. 2017

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“…Prior studies in Brazil have reported median OS similar to our findings (Araujo et al., 2014; Younes, Pereira, Fares, & Gross, 2011). The median OS of 25.5 months in our Taiwanese cohort could be the result of frequent and appropriate therapy with EGFR TKIs for patients with EGFR ‐positive status, since gefitinib was approved for first‐line therapy of EGFR ‐positive NSCLC in Taiwan in June 2011.…”

Section: Discussionmentioning

confidence: 99%

Systemic therapy treatment patterns in patients with advanced non-small cell lung cancer (NSCLC): PIvOTAL study

et al. 2017

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The aim of this multinational retrospective cohort study, conducted at academic and community oncology centres, was to describe real‐world treatment patterns for patients with a confirmed diagnosis of advanced/metastatic (stage IIIB/IV) non‐small cell lung cancer (NSCLC) who initiated first‐line systemic therapy from January 2011 through June 2014. The study included 1265 patients in Italy, Spain, Germany, Australia, Korea, Taiwan and Brazil. The proportion of patients with squamous versus non‐squamous NSCLC was approximately 20% versus 75%, and associated patient demographic characteristics were similar in all countries, excepting race. Patients with squamous NSCLC were predominantly male and current/ex‐smokers. Biomarker tests were performed for the majority of patients with non‐squamous NSCLC, ranging from 54% (Brazil) to 91% in Taiwan, where, of those tested, 68% with non‐squamous NSCLC had positive epidermal growth factor receptor (EGFR)‐mutation status; in other countries the EGFR‐positive percentages ranged from 17% (Spain/Brazil) to 40% (Korea). Platinum‐based regimens were the most common first‐line therapy in all countries except Taiwan, where gefitinib was the most common first‐line agent. Median overall survival ranged from 9.3 months (Brazil) to 25.5 months (Taiwan). The diagnostic and treatment patterns recorded in this study were heterogeneous but largely in line with NSCLC guidelines during the study period.

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“…More than 50% of NSCLC patients are at an advanced stage at the time of diagnosis, and they are characterized by a poor prognosis. In addition, 40-70% of the early stage NSCLC patients develop distant metastases throughout the course of the disease, despite curative surgical intervention [3][4][5]. Systemic treatment is the basic treatment approach for advanced-stage NSCLC; some patients receive radiotherapy if needed, and other specific patients may undergo surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Immune Checkpoint Inhibitors in Advanced-Stage Non-small Cell Lung Cancer

Kazaz

Öztop

2017

Turk Thorac J

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More than half of non-small cell lung cancer (NSCLC) patients are at an advanced stage at the time of diagnosis, and they have a poor prognosis. Systemic treatment is the basic treatment approach for advanced-stage NSCLC, and chemotherapy and targeted treatments are commonly used based on the molecular characteristics. Although targeted therapies have led to a significant level of improvement in terms of survival, the results are still unsatisfactory. However, considerable attention has been focused to the immunotherapy with recent positive results reported by studies on this field. In this context, a certain portion of clinical studies have shown dramatic results, and these have involved inhibitors developed particularly against the immune checkpoint protein programmed death receptor-1 and its ligand (programmed death ligand-1). This review aims to present the significance of immune checkpoint inhibitors in NSCLC and to summarize the findings of relevant contemporary clinical studies. KEYWORDS: Non-small cell lung cancer, immunotherapy, checkpoint inhibitors INTRODUCTIONLung cancer is the leading cause of cancer-related death for both genders worldwide and poses a serious public health problem [1,2]. Non-small cell lung cancer (NSCLC) comprises approximately 85% of all lung cancers. More than 50% of NSCLC patients are at an advanced stage at the time of diagnosis, and they are characterized by a poor prognosis. In addition, 40-70% of the early stage NSCLC patients develop distant metastases throughout the course of the disease, despite curative surgical intervention [3][4][5]. Systemic treatment is the basic treatment approach for advanced-stage NSCLC; some patients receive radiotherapy if needed, and other specific patients may undergo surgical intervention. With regard to the planning of systemic treatment, the decision is made by taking patient-and tumor-related factors into account. Primary patient-related factors include age, performance status, and comorbidity, and main tumor-related factors include classification of the histological type and molecular analysis of the tumor, which are of key importance [6,7]. Today, recommended molecular analyses are epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) fusion oncogene and C-ros oncogene 1 analyses. After performing these analyses, relevant patients receive targeted treatments (erlotinib, gefitinib, afatinib, or crizotinib), while others are treated with systemic chemotherapy. These approaches extend the survival time and increase the quality of life. In addition, there are recent studies available on the BRAF, RAS, and MET pathways, all of which have reported considerably positive findings [8][9][10]. The agents targeting these pathways may be used in this field in the near future.Recently, we have witnessed a key development in the field of immunotherapy for the treatment of NSCLC. A better identification of the immune pathways playing a role in tumor progression and growth in lung cancer, which is known to have a relativ...

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Chemotherapy beyond first-line in stage IV metastatic non-small cell lung cancer

Abstract: Second-line chemotherapy is a therapeutic strategy that should be considered for a selected group of patients. Performance status and response to first-line chemotherapy could be determinant characteristics to select patients who might be treated beyond first-line chemotherapy.

Cited by 21 publications

References 30 publications

Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: A systematic review of recently published studies

Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: A systematic review of recently published studies

Systemic therapy treatment patterns in patients with advanced non-small cell lung cancer (NSCLC): PIvOTAL study

Immune Checkpoint Inhibitors in Advanced-Stage Non-small Cell Lung Cancer

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