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
Alectinib for Patients with ALK Rearrangement–Positive Non–Small Cell Lung Cancer and a Poor Performance Status (Lung Oncology Group in Kyushu 1401)
Introduction : Alectinib has shown marked efficacy and safety in patients with anaplastic lymphoma receptor tyrosine kinase gene ( ALK ) rearrangement – positive NSCLC and a good performance status ( PS ) . It has remained unclear whether alectinib might also be beneficial for such patients with a poor PS . Methods : Eligible patients with advanced ALK rearrangement – positive NSCLC and a PS of 2 to 4 received alectinib orally at 300 mg twice daily . The primary end point of the study was objective response rate ( ORR ) , and the most informative secondary end point was rate of PS improvement . Results : Between September 2014 and December 2015 , 18 patients were enrolled in this phase II study . Of those patients , 12 , five , and one had a PS of 2 , 3 , or 4 , respectively , whereas four patients had received prior crizotinib treatment . The ORR was 72.2 % ( 90 % confidence interval : 52.9–85.8 % ) . The ORR did not differ significantly between patients with a PS of 2 and those with a PS of 3 or higher ( 58.3 % and 100 % , respectively [ p = 0.114 ] ) . The PS improvement rate was 83.3 % ( 90 % confidence interval : 64.8–93.1 % , p < 0.0001 ) , with the frequency of improvement to a PS of 0 or 1 being 72.2 % . The median progression‐free survival was 10.1 months . Toxicity was mild , with the frequency of adverse events of grade 3 or higher being low . Neither dose reduction nor withdrawal of alectinib because of toxicity was necessary . Conclusions : Alectinib is a treatment option for patients with ALK rearrangement – positive NSCLC and a poor PS
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