BACKGROUND: Despite advances in palliative chemotherapy, @entity1 with advanced @entity1149 ( @entity1149 ) eventually experience disease progression during or after completion of first-line chemotherapy, which requires salvage therapy. Second- or third-line therapy in selected @entity1 is recommended in the current guidelines. Although fourth-line therapy is often performed in daily practice in some countries, there are few reports about the clinical benefits of fourth-line therapy. @entity1 AND METHODS: A retrospective review was conducted on 383 @entity1 who underwent at least first-line palliative chemotherapy for advanced @entity1149 (stage IV or stage IIIB/recurrent disease unsuitable for definitive local therapy). @entity1349 ( @entity1349 ) and clinicopathological characteristics were analyzed according to the lines of chemotherapy as well as for all study @entity1 . RESULTS: The median @entity1349 for all @entity1 after the initiation of first-line therapy was 11 months. The median @entity1349 for @entity1 who received fourth- or further-line therapy (77 @entity1 ) was longer than that of @entity1 who received third- or lesser-line therapy (27 versus 9 months, p<0.0001). In multivariate analysis, fourth- or further-line therapy was independently associated with favorable @entity1349 (hazard ratio: 0.44, 95% confidence interval: 0.34-0.57, p<0.0001) along with recurrent disease, female, age <70 years, and ECOG performance status (PS) 0 or 1. Median @entity1349 after the start of fourth-line therapy was 9 months. Good PS (ECOG PS 0, 1) at the initiation of fourth-line therapy (10 versus 2 months, p<0.0001) and disease control (10 versus 7 months, p=0.011) after first-line therapy were associated with favorable @entity1349 in univariate analysis, while poor PS (ECOG PS >= 2) was an independent prognostic factor for poor outcome (p<0.0001). CONCLUSION: The present study suggests that advanced @entity1149 @entity1 with good PS after progression from third-line therapy could be considered as reasonable candidates for fourth-line therapy in clinical practice.

Is fourth-line chemotherapy routine practice in advanced XXXX ?

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small cell lung cancer'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'Overall survival']
@entity1149 :: (MESH:D002289,Disease) :: ['non-small cell lung cancer']
