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
PRONOUNCE: Randomized, Open-Label, Phase III Study of First-Line Pemetrexed + Carboplatin Followed by Maintenance Pemetrexed versus Paclitaxel + Carboplatin + Bevacizumab Followed by Maintenance Bevacizumab in Patients ith Advanced Nonsquamous Non–Small-Cell Lung Cancer
Introduction : PRONOUNCE compared the efficacy and safety of pemetrexed+carboplatin followed by pemetrexed ( Pem+Cb ) with paclitaxel+carboplatin+bevacizumab followed by bevacizumab ( Pac+Cb+Bev ) in patients with advanced nonsquamous non – small-cell lung cancer ( NSCLC ) . Methods : Patients ≥18 years of age with stage IV nonsquamous NSCLC ( American Joint Committee on Cancer v7.0 ) , and Eastern Cooperative Oncology Group performance status 0/1 were r and omized ( 1:1 ) to four cycles of induction Pem+Cb ( pemetrexed , 500 mg/m2 , carboplatin , area under the curve = 6 ) followed by Pem maintenance or Pac+Cb+Bev ( paclitaxel , 200 mg/m2 , carboplatin , area under the curve = 6 , and bevacizumab , 15 mg/kg ) followed by Bev maintenance in the absence of progressive disease or discontinuation . The primary objective was progression-free survival ( PFS ) without grade 4 toxicity ( G4PFS ) . Secondary end points were PFS , overall survival ( OS ) , overall response rate ( ORR ) , disease control rate ( DCR ) , and safety . Re source utilization was also assessed . Results : Baseline characteristics of the patients r and omized to Pem+Cb ( N = 182 ) and Pac+Cb+Bev ( N = 179 ) were well balanced between the arms . Median ( months ) G4PFS was 3.91 for Pem+Cb and 2.86 for Pac+Cb+Bev ( hazard ratio = 0.85 , 90 % confidence interval , 0.7–1.04 ; p = 0.176 ) ; PFS , OS , ORR , or DCR did not differ significantly between the arms . Significantly more drug-related grade 3/4 anemia ( 18.7 % versus 5.4 % ) and thrombocytopenia ( 24.0 % versus 9.6 % ) were reported for Pem+Cb . Significantly more grade 3/4 neutropenia ( 48.8 % versus 24.6 % ) , grade 1/2 alopecia ( 28.3 % versus 8.2 % ) , and grade 1/2 sensory neuropathy were reported for Pac+Cb+Bev . Number of hospitalizations and overall length of stay did not differ significantly between the arms . Conclusions : Pem+Cb did not produce significantly better G4PFS compared with Pac+Cb+Bev . Pem+Cb was not superior in PFS , OS , ORR , or DCR compared with Pac+Cb+Bev . Both regimens were well tolerated , although , toxicity profiles differed
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