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
Gemcitabine plus best supportive care (BSC) vs BSC in inoperable non-small cell lung cancer – a randomized trial with quality of life as the primary outcome
Three hundred patients with symptomatic , locally advanced or metastatic NSCLC not requiring immediate radiotherapy were enrolled into this r and omized multicentre trial comparing gemcitabine + BSC vs BSC alone . Patients allocated gemcitabine received 1000 mg/m2on days 1 , 8 and 15 of a 28-day cycle , for a maximum of six cycles . The main aim of this trial was to compare patient assessment of a predefined subset of commonly reported symptoms ( SS14 ) from the EORTC QLQ-C30 and LC13 scales . The primary end-points were defined as ( 1 ) the percentage change in mean SS14 score between baseline and 2 months and ( 2 ) the proportion of patients with a marked ( ≥ 25 % ) improvement in SS14 score between baseline and 2 months sustained for ≥4 weeks . The secondary objectives were to compare treatments with respect to overall survival , and multidimensional QL parameters . The treatment groups were balanced with regard to age , gender , Karnofsky performance status ( KPS ) and disease stage ( 40 % had metastatic disease ) . The percentage change in mean SS14 score from baseline to 2 months was a 10 % decrease ( i.e. improvement ) for gemcitabine plus BSC and a 1 % increase ( i.e. deterioration ) for BSC alone ( P = 0.113 , two- sample t -test ) . A sustained ( ≥ 4 weeks ) improvement ( ≥25 % ) on SS14 was recorded in a significantly higher proportion of gemcitabine + BSC patients ( 22 % ) than in BSC alone patients ( 9 % ) ( P = 0.0014 , Pearson 's chi-squared test ) . The QLQ-C30 and L13 subscales showed greater improvement in the gemcitabine plus BSC arm ( in 11 domains ) than in the BSC arm ( one symptom item ) . There was greater deterioration in the BSC alone arm ( six domains/items ) than in the gemcitabine + BSC arm ( three QL domains ) . Tumour response occurred in 19 % ( 95 % CI 13–27 ) of gemcitabine patients . There was no difference in overall survival : median 5.7 months ( 95 % CI 4.6–7.6 ) for gemcitabine + BSC patients and 5.9 months ( 95 % CI 5.0–7.9 ) ( log-rank , P = 0.84 ) for BSC  patients , and 1-year survival was 25 % for gemcitabine + BSC and 22 % for BSC . Overall , 74 ( 49 % ) gemcitabine + BSC patients and 119 ( 79 % ) BSC patients received palliative radiotherapy .  The median time to radiotherapy was 29 weeks for gemcitabine + BSC patients and 3.8 weeks for BSC . Patients treated with gemcitabine + BSC reported better QL and reduced disease-related symptoms compared with those receiving BSC alone . These improvements in patient-assessed QL were significant in magnitude and were sustained . © 2000 Cancer Research
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