2011 Focused update of 2009 American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV non-small-cell lung cancer Journal Article
| Authors: | Azzoli, C. G.; Temin, S.; Aliff, T.; Baker, S. Jr; Brahmer, J.; Johnson, D. H.; Laskin, J. L.; Masters, G.; Milton, D.; Nordquist, L.; Pao, W.; Pfister, D. G.; Piantadosi, S.; Schiller, J. H.; Smith, R.; Smith, T. J.; Strawn, J. R.; Trent, D.; Giaccone, G. |
| Article Title: | 2011 Focused update of 2009 American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV non-small-cell lung cancer |
| Abstract: | 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. © 2011 by American Society of Clinical Oncology. |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 29 |
| Issue: | 28 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2011-10-01 |
| Start Page: | 3825 |
| End Page: | 3831 |
| Language: | English |
| DOI: | 10.1200/jco.2010.34.2774 |
| PROVIDER: | scopus |
| PUBMED: | 21900105 |
| PMCID: | PMC3675703 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2011" - "CODEN: JCOND" - "Source: Scopus" |
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