Does second-line therapy for non-small cell lung cancer (NSCLC) result in symptom palliation? Analysis of 484 patients from a randomized trial of pemetrexed vs docetaxel

Marinis, Filippo de; Pereira, José Rodrígues; Park, K.; Leong, S. S.; Tsai, Chih–Chien; Ansari, Tariq; Perry, Michael C.; Liepa, Astra M.; Paul, Steven; Gralla, Richard J.

doi:10.1200/jco.2004.22.14_suppl.7035

Cited by 5 publications

(3 citation statements)

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“…In the two arms of treatment the percentages of patients reporting improvement or stabilization for anorexia, fatigue, cough, dyspnea, hemoptysis and pain were almost superimposable. Although no difference was seen between the two arms, overall patients who showed a major response had an improvement in symptoms from baseline of 9.9 points, which was significantly higher than the improvement achieved by patients with disease stabilization (4.3 points), while patients with PD worsened (-3.7 points) [67] .…”

Section: Phase III Trialsmentioning

confidence: 59%

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Does an optimal therapeutic sequence exist in advanced non-small cell lung cancer?

Gebbia

2008

Expert Opinion on Pharmacotherapy

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Background : A growing percentage of patients affected by advanced non-small cell lung cancer who progressed after first-line chemotherapy still have a good performance status and require second-line treatment.Objective : An overview of the state of the art of second-line therapeutic options is presented. Methods : The scope of the review is to give an update on the therapeutic options currently available for the second-line treatment of patients with advanced non-small cell lung cancer. Results and conclusions : Among chemotherapeutic drugs docetaxel and pemetrexed have been approved for second-line treatment of advanced non-small cell lung cancer. Although the drugs are equiactive in terms of response rate and survival parameters the latter has a clear-cut advantage in terms of tolerability and quality of life. Therefore, pemetrexed is considered the best second-line therapeutic option in order to avoid severe side effects. Among biologic agents the tyrosine kinase inhibitors gefinitib and erlotinib have been largely tested, but only the latter has been approved for second-and third-line treatment. Erlotinib has been reported to be particularly active in patients with adenocarcinoma, in females, in patients of Asian ethnicity and in epidermal growth factor receptor mutations and it is also active in the third-line setting. At present, no direct head to head comparison of erlotinib with any chemotherapeutic agent has been performed. A rational decision tree may therefore include pemetrexed or docetaxel (the former preferred for tolerability) or erlotinib as standard second-line therapy. Erlotinib has been also shown to be active as third-line treatment: however, in cases of patients with clinical characteristics suggesting a good response to tyrosine kinase inhibitors, erlotinib may be employed in an earlier phase.

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Section: Phase III Trialsmentioning

confidence: 59%

“…The multivariate analysis showed that pemetrexed and docetaxel achieved similar survival after adjusting for all baseline factors [62,67,71] . Prognostic factors were evaluated with a Cox multiple regression analysis.…”

Section: Phase III Trialsmentioning

confidence: 87%

Does an optimal therapeutic sequence exist in advanced non-small cell lung cancer?

Gebbia

2008

Expert Opinion on Pharmacotherapy

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“…Patients achieving tumour response or stable disease have a greater likelihood of reporting a better symptom control than those with progressive disease [23].…”

Section: Is One Single-agent Chemotherapy Superior To Another?mentioning

confidence: 99%