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

被引:631
作者
Azzoli, Christopher G. [1 ]
Baker, Sherman, Jr.
Temin, Sarah
Pao, William
Aliff, Timothy
Brahmer, Julie
Johnson, David H.
Laskin, Janessa L.
Masters, Gregory
Milton, Daniel
Nordquist, Luke
Pfister, David G.
Piantadosi, Steven
Schiller, Joan H.
Smith, Reily
Smith, Thomas J.
Strawn, John R.
Trent, David
Giaccone, Giuseppe
机构
[1] Amer Soc Clin Oncol, Alexandria, VA 22314 USA
关键词
GROWTH-FACTOR-RECEPTOR; PHASE-III TRIAL; CISPLATIN PLUS GEMCITABINE; GENE COPY NUMBER; QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIALS; PLATINUM-BASED CHEMOTHERAPY; INDIVIDUAL PATIENT DATA; MESSENGER-RNA EXPRESSION; LEUKEMIA GROUP-B;
D O I
10.1200/JCO.2009.23.5622
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
The purpose of this article is to provide updated recommendations for the treatment of patients with stage IV non-small-cell lung cancer. A literature search identified relevant randomized trials published since 2002. The scope of the guideline was narrowed to chemotherapy and biologic therapy. An Update Committee reviewed the literature and made updated recommendations. One hundred sixty-two publications met the inclusion criteria. Recommendations were based on treatment strategies that improve overall survival. Treatments that improve only progression-free survival prompted scrutiny of toxicity and quality of life. For first-line therapy in patients with performance status of 0 or 1, a platinum-based two-drug combination of cytotoxic drugs is recommended. Nonplatinum cytotoxic doublets are acceptable for patients with contraindications to platinum therapy. For patients with performance status of 2, a single cytotoxic drug is sufficient. Stop first-line cytotoxic chemotherapy at disease progression or after four cycles in patients who are not responding to treatment. Stop two-drug cytotoxic chemotherapy at six cycles even in patients who are responding to therapy. The first-line use of gefitinib may be recommended for patients with known epidermal growth factor receptor (EGFR) mutation; for negative or unknown EGFR mutation status, cytotoxic chemotherapy is preferred. Bevacizumab is recommended with carboplatin-paclitaxel, except for patients with certain clinical characteristics. Cetuximab is recommended with cisplatin-vinorelbine for patients with EGFR-positive tumors by immunohistochemistry. Docetaxel, erlotinib, gefitinib, or pemetrexed is recommended as second-line therapy. Erlotinib is recommended as third-line therapy for patients who have not received prior erlotinib or gefitinib. Data are insufficient to recommend the routine third-line use of cytotoxic drugs. Data are insufficient to recommend routine use of molecular markers to select chemotherapy. J Clin Oncol 27:6251-6266. (c) 2009 by American Society of Clinical Oncology
引用
收藏
页码:6251 / 6266
页数:16
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