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
Maintenance bevacizumab-pemetrexed after first-line cisplatin-pemetrexed-bevacizumab for advanced nonsquamous nonsmall-cell lung cancer: updated survival analysis of the AVAPERL (MO22089) randomized phase III trial.
BACKGROUND The r and omized , phase III AVAPERL trial evaluated the safety and efficacy of bevacizumab maintenance with or without pemetrexed in nonsquamous nonsmall-cell lung cancer ( nsNSCLC ) .  Progression-free survival ( PFS ) was significantly prolonged with bevacizumab-pemetrexed , but overall survival ( OS ) data were immature . In this article , we report an independent , up date d analysis of survival outcomes in AVAPERL . PATIENTS AND METHODS Patients with advanced nsNSCLC received first-line bevacizumab ( 7.5 mg/kg ) , cisplatin ( 75 mg/m(2 ) ) , and pemetrexed ( 500 mg/m(2 ) ) every 3 weeks ( q3w ) for four cycles . Nonprogressing patients were r and omized to maintenance bevacizumab ( 7.5 mg/kg ) or bevacizumab-pemetrexed ( 500 mg/m(2 ) ) q3w until progression or consent withdrawal . The primary end point of the trial was PFS ; in this independent OS analysis , participating study centers were contacted to collect survival data on patients still alive at the time of the first analysis . RESULTS A total of 376 patients received induction treatment . Disease control was confirmed in 71.9 % of patients ; 253 patients were r and omized to maintenance treatment with bevacizumab ( n = 125 ) or bevacizumab-pemetrexed ( n = 128 ) . At a median follow-up of 14.8 months , patients allocated to bevacizumab-pemetrexed had significantly improved PFS versus those on bevacizumab when measured from r and omization [ 7.4 versus 3.7 months , hazard ratio ( HR ) , 0.57 , 95 % confidence interval ( CI ) 0.44 - 0.75 ) ; P < 0.0001 ] . OS events occurred in 58 % of all patients . OS was numerically longer with bevacizumab-pemetrexed versus bevacizumab when measured from r and omization [ 17.1 versus 13.2 months , HR 0.87 ( 0.63 - 1.21 ) ; P = 0.29 ] . Second-line therapy was administered in 77 % and 70 % of patients in the bevacizumab and bevacizumab-pemetrexed arms , respectively . No new adverse events were reported during this up date d analysis . CONCLUSION In an unselected population of nsNSCLC patients achieving disease control on platinum-based induction therapy , maintenance with bevacizumab-pemetrexed was associated with a nonsignificant increase in OS over bevacizumab alone
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