We believe that this attempt enables clinicians to choose appropriate treatment easier .
According to rapid development of chemotherapy in advanced non-small cell lung cancer ( NSCLC ) , the Japan Lung Cancer Society has been up date d its own guideline annually since 2010 .
Recently , we have had various types of chemotherapeutic drugs like kinase inhibitors or immune-checkpoint inhibitors .
Thus , the guideline proposes to categorize patients into three entities : ( 1 ) driver oncogene-positive , ( 2 ) PD-L1 ≥ 50 % , and ( 3 ) others .
Here , we report an English version of the Japan Lung Cancer Society Guidelines 2018 for NSCLC , stages IV
Improvement in Overall Survival in a Randomized Study That Compared Dacomitinib With Gefitinib in Patients With Advanced Non-Small-Cell Lung Cancer and EGFR-Activating Mutations.
Purpose ARCHER 1050 , a r and omized , open-label , phase III study of dacomitinib versus gefitinib in treatment-naïve patients with advanced non-small-cell lung cancer ( NSCLC ) and activating mutations in EGFR , reported significant improvement in progression-free survival with dacomitinib . The mature overall survival ( OS ) analysis for the intention-to-treat population is presented here . Patients and Methods In this multinational , multicenter study , patients age 18 years or older ( ≥ 20 years in Japan and Korea ) who had an Eastern Cooperative Oncology Group performance status of 0 or 1 and newly diagnosed NSCLC with activating mutations in EGFR ( exon 19 deletion or exon 21 L858R ) were enrolled and r and omly assigned in a 1:1 manner to dacomitinib ( n = 227 ) or gefitinib ( n = 225 ) . R and om assignment was stratified by race ( Japanese , Chinese , other East Asian , or non-Asian ) and EGFR mutation type . The final OS analysis was conducted with a data cutoff date of February 17 , 2017 ; at that time 220 deaths ( 48.7 % ) were observed . Results During a median follow-up time of 31.3 months , 103 ( 45.4 % ) and 117 ( 52.0 % ) deaths occurred in the dacomitinib and gefitinib arms , respectively . The estimated hazard ratio for OS was 0.760 ( 95 % CI , 0.582 to 0.993 ; two-sided P = .044 ) . The median OS was 34.1 months with dacomitinib versus 26.8 months with gefitinib . The OS probabilities at 30 months were 56.2 % and 46.3 % with dacomitinib and gefitinib , respectively . Preliminary subgroup analyses for OS that are based on baseline characteristics were consistent with the primary OS analysis . Conclusion In patients with advanced NSCLC and EGFR activating mutations  , dacomitinib is the first second-generation epidermal growth factor receptor tyrosine kinase inhibitor ( TKI ) to show significant improvement in OS in a phase III r and omized study compared with a st and ard-of-care TKI . Dacomitinib should be considered one of the st and ard treatment options for these patients
We believe that this attempt enables clinicians to choose appropriate treatment easier .
According to rapid development of chemotherapy in advanced non-small cell lung cancer ( NSCLC ) , the Japan Lung Cancer Society has been up date d its own guideline annually since 2010 .
Recently , we have had various types of chemotherapeutic drugs like kinase inhibitors or immune-checkpoint inhibitors .
Thus , the guideline proposes to categorize patients into three entities : ( 1 ) driver oncogene-positive , ( 2 ) PD-L1 ≥ 50 % , and ( 3 ) others .
Here , we report an English version of the Japan Lung Cancer Society Guidelines 2018 for NSCLC , stages IV