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 prospective, multicentre phase II trial of low-dose erlotinib in non-small cell lung cancer patients with EGFR mutations pretreated with chemotherapy: Thoracic Oncology Research Group 0911.
BACKGROUND Low-dose erlotinib may be as effective as gefitinib or erlotinib at full dose in non-small cell lung cancer ( NSCLC ) patients with activating mutations of the epidermal growth factor receptor ( EGFR ) gene . METHODS Patients with chemotherapy pretreated NSCLC harbouring EGFR mutations received erlotinib at 50 mg/d until disease progression or unacceptable toxicities . The dose was escalated to 150 mg/d in patients showing no response ( i.e. without major tumour shrinkage according to Response Evaluation Criteria in Solid Tumours ( RECIST ) ) to the initial dose during the first 4 weeks . The primary end-point was the objective response rate at the dose of 50 mg/d . RESULTS Thirty-four patients from seven institutes were enrolled . The study was closed early when no response was confirmed in 15 patients , excluding the possibility that the primary end-point would be met . The objective response and disease control rates at the dose of 50 mg/d as determined by an independent review committee were 54.5 % and 84.8 % , respectively . Four additional patients achieved partial response with increased 150 mg/d dose . Progression-free survival and median survival times during the entire period of the study were 9.5 and 28.5 months , respectively . Treatment-related toxicities were generally mild , the most common being skin disorders and diarrhoea . Only one case experienced grade 3 toxicity , which was transient increase of hepatic enzymes . CONCLUSION The primary end-point was not met ; low-dose erlotinib is not recommended for fit patients with NSCLC harbouring EGFR mutations . However , it may merit further evaluation for elderly or frail 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