2011 Focused Update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer

被引：228

作者：

Azzoli, Christopher G. ^{[2
]}

Temin, Sarah ^{[1
]}

Aliff, Timothy ^{[5
]}

Baker, Sherman, Jr. ^{[3
]}

Brahmer, Julie ^{[6
]}

Johnson, David H. ^{[8
]}

Laskin, Janessa L. ^{[9
]}

Masters, Gregory ^{[10
]}

Milton, Daniel ^{[11
]}

Nordquist, Luke ^{[12
]}

Pao, William ^{[13
]}

Pfister, David G. ^{[2
]}

Piantadosi, Steven ^{[14
]}

Schiller, Joan H. ^{[8
]}

Smith, Reily

Smith, Thomas J. ^{[3
]}

Strawn, John R.

Trent, David ^{[4
]}

Giaccone, Giuseppe ^{[7
]}

机构：

[1] Amer Soc Clin Oncol, Alexandria, VA 22314 USA

[2] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[3] Virginia Commonwealth Univ, Massey Canc Ctr, Richmond, VA 23284 USA

[4] Virginia Canc Ctr, Richmond, VA USA

[5] NW Oncol & Hematol Associates, Coral Springs, FL USA

[6] Johns Hopkins Univ, Sidney Kimmel Canc Comprehens Ctr, Baltimore, MD USA

[7] NCI, Bethesda, MD 20892 USA

[8] Univ Texas Dallas, SW Med Ctr, Dallas, TX USA

[9] British Columbia Canc Agcy, Vancouver, BC V5Z 4E6, Canada

[10] Helen F Graham Canc Ctr, Newark, DE USA

[11] Hematol Oncol Indiana, Indianapolis, IN USA

[12] Nebraska Canc Specialists, Omaha, NE USA

[13] Vanderbilt Ingram Canc Ctr, Nashville, TN USA

[14] Samuel Oschin Comprehens Canc Ctr Inst, Los Angeles, CA USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2011年 / 29卷 / 28期

关键词：

PHASE-III TRIAL; THERAPY; GEMCITABINE; DOCETAXEL; PLACEBO; GEFITINIB; ERLOTINIB;

D O I：

10.1200/JCO.2010.34.2774

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose An American Society of Clinical Oncology (ASCO) focused update updates a single recommendation (or subset of recommendations) in advance of a regularly scheduled guideline update. This document updates one recommendation of the ASCO Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer (NSCLC) regarding switch maintenance chemotherapy. Clinical Context Recent results from phase III clinical trials have demonstrated that in patients with stage IV NSCLC who have received four cycles of first-line chemotherapy and whose disease has not progressed, an immediate switch to alternative, single-agent chemotherapy can extend progression-free survival and, in some cases, overall survival. Because of limitations in the data, delayed treatment with a second-line agent after disease progression is also acceptable. Recent Data Seven randomized controlled trials of carboxyaminoimidazole, docetaxel, erlotinib, gefitinib, gemcitabine, and pemetrexed have evaluated outcomes in patients who received an immediate, non-cross resistant alternative therapy (switch maintenance) after first-line therapy. Recommendation In patients with stage IV NSCLC, first-line cytotoxic chemotherapy should be stopped at disease progression or after four cycles in patients whose disease is stable but not responding to treatment. Two-drug cytotoxic combinations should be administered for no more than six cycles. For those with stable disease or response after four cycles, immediate treatment with an alternative, single-agent chemotherapy such as pemetrexed in patients with nonsquamous histology, docetaxel in unselected patients, or erlotinib in unselected patients may be considered. Limitations of this data are such that a break from cytotoxic chemotherapy after a fixed course is also acceptable, with initiation of second-line chemotherapy at disease progression. J Clin Oncol 29: 3825-3831. (C) 2011 by American Society of Clinical Oncology

引用

页码：3825 / 3831

页数：7

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