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
A randomized, double-blind, phase II study of ramucirumab plus docetaxel vs placebo plus docetaxel in Japanese patients with stage IV non-small cell lung cancer after disease progression on platinum-based therapy.
OBJECTIVES Ramucirumab plus docetaxel prolongs survival in patients with non-small cell lung cancer ( NSCLC ) with disease progression after platinum-based therapy . This phase II , double-blind , r and omized , placebo-controlled study assessed efficacy and safety of second-line ramucirumab-docetaxel in Japanese patients with NSCLC . MATERIAL S AND METHODS Patients with NSCLC with progression after platinum-based therapy ( 28 Japanese sites ; 19 December , 2012 to 22 May , 2015 ) were r and omized ( computer-generated sequence ) to ramucirumab 10mg/kg or placebo , followed by docetaxel 60mg/m(2 ) ( Day 1 , 21-day cycle ) . Prior epidermal growth factor receptor ( EGFR ) tyrosine kinase inhibitor ( TKI ) monotherapy was prohibited in the primary population , but EGFR mutation-positive NSCLC patients who were treated with EGFR-TKI were enrolled as a separate exploratory population . Primary endpoint was progression-free survival ( PFS ) ; secondary outcomes included overall survival , tumor response rates , and safety . Investigator tumor assessment s were used for the efficacy endpoints . RESULTS In the primary population ( N=160 r and omized , n=157 treated ) , median ( 95 % CI ) PFS was longer with ramucirumab-docetaxel ( 5.22 [ 3.52 - 6.97 ] months ; n=76 ) than with placebo-docetaxel ( 4.21 [ 2.83 - 5.62 ] months ; n=81 ) ; hazard ratio 0.83 ( 95 % CI 0.59 - 1.16 ) . Median ( 95 % CI ) overall survival was 15.15 ( 12.45 - 26.55 ) months with ramucirumab-docetaxel and 14.65 ( 11.93 - 24.44 ) months with placebo-docetaxel ( hazard ratio [ 95 % CI ] 0.86 [ 0.56 - 1.32 ] ) . Objective response rate ( 28.9 % vs 18.5 % ) and disease control rate ( 78.9 % vs 70.4 % ) were numerically greater with ramucirumab-docetaxel than with placebo-docetaxel . Incidence and severity of most adverse events were similar , but febrile neutropenia was more common with ramucirumab-docetaxel ( 34.2 % ) than with placebo-docetaxel ( 19.8 % ) . CONCLUSION Second-line ramucirumab-docetaxel improved PFS similar to that seen in the REVEL trial with a manageable safety profile in Japanese patients with NSCLC
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