In the third-line setting , for patients who have not received erlotinib or gefitinib , treatment with erlotinib is recommended .
There are insufficient data to recommend routine third-line cytotoxic therapy .
Purpose To provide evidence -based recommendations to up date the American Society of Clinical Oncology guideline on systemic therapy for stage IV non – small-cell lung cancer ( NSCLC ) .
Results This guideline up date reflects changes in evidence since the previous guideline .
Docetaxel versus docetaxel plus gemcitabine as front-line treatment of patients with advanced non-small cell lung cancer: a randomized, multicenter phase III trial.
To compare the overall survival ( OS ) of patients with advanced non-small cell lung ( NSCLC ) treated with either docetaxel plus gemcitabine or single-agent docetaxel .  Chemotherapy-naive patients with advanced/metastatic NSCLC were r and omly assigned to receive either DG [ n=157 ; gemcitabine 1100mg/m(2 ) on days 1 and 8 ] , docetaxel 75mg/m(2 ) on day 8 or D [ n=155 ; docetaxel 100mg/m(2 ) on day 1 ] every 3 weeks . A total of 312 patients were evaluable for toxicity and response .  A predefined interim intention-to-treat analysis showed significantly longer median OS ( p=0.037 ) in favor of the DG regimen ( 9.4 months versus 8.3 months for DG and D regimens , respectively ) , result ing in the premature termination of the study . The DG regimen was also associated with a significantly higher response rate compared to D ( 26.8 % versus 11.6 % , p<0.001 ) . TTP were 3.5 and 2.3 months for the DG and D regimen , respectively ( p=0.054 ) . Although there were two treatment-related deaths in the DG arm , the toxicity profiles of the two regimens were comparable . The DG regimen was associated with a significantly better quality of life . The efficacy of the docetaxel plus gemcitabine combination is superior to single-agent docetaxel in chemonaive patients with advanced NSCLC
In the third-line setting , for patients who have not received erlotinib or gefitinib , treatment with erlotinib is recommended .
There are insufficient data to recommend routine third-line cytotoxic therapy .
Purpose To provide evidence -based recommendations to up date the American Society of Clinical Oncology guideline on systemic therapy for stage IV non – small-cell lung cancer ( NSCLC ) .
Results This guideline up date reflects changes in evidence since the previous guideline .