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 .
Safety and efficacy of weekly nab®-paclitaxel in combination with carboplatin as first-line therapy in elderly patients with advanced non-small-cell lung cancer.
BACKGROUND This analysis evaluates safety and efficacy in elderly ( ≥ 70 years old ) versus younger patients enrolled in a phase III advanced non-small-cell lung cancer ( NSCLC ) trial . PATIENTS AND METHODS Untreated stage IIIB/IV patients with PS 0/1 were r and omly assigned ( 1:1 ) to carboplatin AUC6 , day 1 every 3 weeks , and either nab-paclitaxel ( Abraxane ) 100 mg/m(2 ) weekly ( nab-P/C ) or solvent-based paclitaxel ( Taxol ) 200 mg/m(2 ) day 1 every 3 weeks ( sb-P/C ) . The primary end-point was overall response rate ( ORR ) . RESULTS Fifteen percent of 1052 enrolled patients were elderly : nab-P/C , n = 74 ; sb-P/C , n = 82 . In both age cohorts , the ORR was higher with nab-P/C versus sb-P/C ( age ≥ 70 : 34 % versus 24 % , P = 0.196 ; age < 70 : 32 % versus 25 % , P = 0.013 ) . In elderly patients , progression-free survival ( PFS ) trended in favor of nab-P/C ( median 8.0 versus 6.8 months , hazard ratio ( HR ) 0.687 , P = 0.134 ) , and overall survival ( OS ) was significantly improved ( median 19.9 versus 10.4 months , HR 0.583 , P = 0.009 ) . In younger patients , PFS ( median 6.0 versus 5.8 months , HR 0.903 , P = 0.256 ) and OS ( median 11.4 versus 11.3 months , HR 0.999 , P = 0.988 ) were similar in both arms . Adverse events were similar in both age groups , with less neutropenia ( P = 0.015 ) , neuropathy ( P = 0.001 ) , and arthralgia ( P = 0.029 ) , and increased anemia ( P = 0.007 ) with nab-P/C versus sb-P/C. CONCLUSIONS In elderly NSCLC patients , nab-P/C as first-line therapy was well tolerated and improved the ORR and PFS , with substantially longer OS versus sb-PC
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 .