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 erlotinib versus erlotinib at disease progression in patients with advanced non-small-cell lung cancer who have not progressed following platinum-based chemotherapy (IUNO study).
OBJECTIVE The phase III IUNO trial assessed the benefit of maintenance erlotinib versus erlotinib at progression in advanced/metastatic non-small-cell lung cancer ( NSCLC ) that had not progressed following four cycles of platinum-based chemotherapy .  MATERIAL S AND METHODS Patients had stage IIIB/IV NSCLC , no known epidermal growth factor receptor (EGFR)-activating mutation , and objective response or disease stabilization after platinum-based induction chemotherapy .  Central EGFR-mutation testing was undertaken on tumors from patients with unknown or wild-type EGFR status following local testing . Patients were r and omized to receive blinded maintenance erlotinib 150mg/day ( ' early erlotinib ' ) or placebo . Those who progressed on placebo received open-label erlotinib ( ' late erlotinib ' ) ; patients who progressed on erlotinib received approved second-line chemotherapy or best supportive care . Primary endpoint : overall survival ( OS ) . RESULTS 643 patients were r and omized to receive maintenance erlotinib ( n=322 ) or placebo ( n=321 ) . As of March 23 , 2015 , 242 ( 75.2 % ) OS events had occurred with ' early erlotinib ' versus 235 ( 73.2 % ) with ' late erlotinib ' . Median OS was 9.7 and 9.5 months with ' early erlotinib ' and ' late erlotinib ' , respectively ( HR , 1.02 , 95 % CI : 0.85 - 1.22 ; log-rank p=0.82 ) . No progression-free survival , objective response rate , or disease control rate benefit was observed with maintenance erlotinib . 410 patients entered the second-line phase of the study : 160 patients ( 50 % ) from the maintenance erlotinib arm and 250 patients ( 78 % ) from the maintenance placebo arm . The pattern of adverse events ( AEs ) was consistent with previous trials ; 11 patients who received blinded erlotinib and 3 who received placebo  died during the blinded maintenance phase due to nontreatment-related AEs . CONCLUSIONS OS with maintenance erlotinib was not superior to second-line treatment in patients whose tumor did not harbor an EGFR-activating mutation . Safety results were consistent with the established safety profile of erlotinib . Thus , maintenance treatment with erlotinib in patients with advanced/metastatic NSCLC without EGFR-activating mutations is considered unfavorable
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