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
Multicenter Phase II Study of Whole-Body and Intracranial Activity With Ceritinib in Patients With ALK-Rearranged Non-Small-Cell Lung Cancer Previously Treated With Chemotherapy and Crizotinib: Results From ASCEND-2.
PURPOSE Phase I data ( ASCEND-1 ) showed ceritinib  efficacy in patients with ALK-rearranged non-small-cell lung cancer ( NSCLC ) , regardless of brain metastases status and with or without prior therapy with an inhibitor of the ALK protein . Data are presented from a phase II trial ( ASCEND-2 ) in which ceritinib  efficacy and safety were evaluated in patients who had ALK-rearranged NSCLC previously treated with at least one platinum-based chemotherapy and who had experienced progression during crizotinib treatment as their last prior therapy . PATIENTS AND METHODS Patients with advanced ALK-rearranged NSCLC , including those with asymptomatic or neurologically stable baseline brain metastases , received oral ceritinib 750 mg/d . Whole-body and intracranial responses were investigator assessed ( according to RECIST version 1.1 ) . Patient-reported outcomes were evaluated with the Lung Cancer Symptom Scale and European Organisation for Research and Treatment of Cancer surveys ( the core-30 and the 13-item lung cancer-specific quality -of-life question naires ) . RESULTS All 140 patients enrolled had received two or more previous treatment regimens , and all patients had received crizotinib . The median duration of exposure and the follow-up time with ceritinib were 8.8 months ( range , 0.1 to 19.4 months ) and 11.3 months ( range , 0.1 to 18.9 months ) , respectively . Investigator-assessed overall response rate was 38.6 % ( 95 % CI , 30.5 % to 47.2 % ) . Secondary end points , all investigator assessed , included disease control rate ( 77.1 % ; 95 % CI , 69.3 % to 83.8 % ) , time to response ( median , 1.8 months ; range , 1.6 to 5.6 months ) , duration of response ( median , 9.7 months ; 95 % CI , 7.1 to 11.1 months ) , and progression-free survival ( median , 5.7 months ; 95 % CI , 5.4 to 7.6 months ) . Of 100 patients with baseline brain metastases , 20 had active target lesions at baseline ; investigator-assessed intracranial overall response rate was 45.0 % ( 95 % CI , 23.1 % to 68.5 % ) . The most common adverse events ( majority , grade 1 or 2 ) for all treated patients were nausea ( 81.4 % ) , diarrhea ( 80.0 % ) , and vomiting ( 62.9 % ) . Patient-reported outcomes showed a trend toward improved symptom burden . The global quality -of-life score was maintained during treatment . CONCLUSION Consistent with its activity in ASCEND-1 , ceritinib treatment provided clinical ly meaningful and durable responses with manageable tolerability in chemotherapy- and crizotinib-pretreated patients , including those with brain metastases
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