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
Randomized controlled trial of S-1 versus docetaxel in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy (East Asia S-1 Trial in Lung Cancer)
Abstract Background Chemotherapy remains a viable option for the management of advanced non-small-cell lung cancer ( NSCLC ) despite recent advances in molecular targeted therapy and immunotherapy . We evaluated the efficacy of oral 5-fluorouracil-based S-1 as second- or third-line therapy compared with st and ard docetaxel therapy in patients with advanced NSCLC . Patients and methods Patients with advanced NSCLC previously treated with ≥1 platinum-based therapy were r and omized 1 : 1 to docetaxel ( 60 mg/m2 in Japan , 75 mg/m2 at all other study sites ; day 1 in a 3-week cycle ) or S-1 ( 80–120 mg/day , depending on body surface area ; days 1–28 in a 6-week cycle ) . The primary endpoint was overall survival . The non-inferiority margin was a hazard ratio ( HR ) of 1.2 . Results A total of 1154 patients ( 577 in each arm ) were enrolled , with balanced patient characteristics between the two arms . Median overall survival was 12.75 and 12.52 months in the S-1 and docetaxel arms , respectively [ HR 0.945 ; 95 % confidence interval ( CI ) 0.833–1.073 ; P = 0.3818 ] . The upper limit of 95 % CI of HR fell below 1.2 , confirming non-inferiority of S-1 to docetaxel  . Difference in progression-free survival between treatments was not significant ( HR 1.033 ; 95 % CI 0.913–1.168 ; P = 0.6080 ) . Response rate was 8.3 % and 9.9 % in the S-1 and docetaxel arms , respectively . Significant improvement was observed in the EORTC QLQ-C30 global health status over time points in the S-1 arm . The most common adverse drug reactions were decreased appetite ( 50.4 % ) , nausea ( 36.4 % ) , and diarrhea ( 35.9 % ) in the S-1 arm , and neutropenia ( 54.8 % ) , leukocytopenia ( 43.9 % ) , and alopecia ( 46.6 % ) in the docetaxel arm . Conclusion S-1 is equally as efficacious as docetaxel and offers a treatment option for patients with previously treated advanced NSCLC . Clinical trial number Japan Pharmaceutical Information Center , JapicCTI-101155
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