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

Health-Related Quality-of-Life in a Randomized Phase III First-Line Study of Gefitinib Versus Carboplatin/Paclitaxel in Clinically Selected Patients from Asia with Advanced NSCLC (IPASS)

“…Studies in patients with NSCLC have supported the hypothesis that tumor response and symptom improvement to treatment are related. [12][13][14][15] The IDEAL I study reported an improvement in disease-related symptoms in most patients whose tumors responded to gefitinib 250 mg, 14 with 70% of those with stable disease also reporting symptom improvement (versus 12% of patients with a best overall response of progression). 14 In the IDEAL II study, symptoms improved in 43% of patients treated with gefitinib 250 mg and improved in all patients with partial responses.…”

Lung Cancer

“… 92 , 93 A recently reported phase III randomized trial has shown similar efficacy with pemetrexed in this setting. 94 Recently reported data also suggests that gemcitabine may have activity in second-line setting. 95 , 96 …”

Lung Cancer Symptom Scale Outcomes in Relation to Standard Efficacy Measures: An Analysis of the Phase III Study of Pemetrexed Versus Docetaxel in Advanced Non-small Cell Lung Cancer

“…They include all randomized patients, but necessarily excluded any patient missing the baseline LCSS assessment or missing all postbaseline LCSS assessments. The first analysis considered maximum improvement in patient-reported scores as previously reported by de Marinis et al 6 For each of the nine LCSS items, for each individual patient, maximum improvement was defined as the largest reduction in on-study scores from the baseline score. The mean maximum improvement for each item was categorized according to best tumor response.…”

“…3 Further analysis of the LCSS data examined the maximum improvement per item and revealed that in both treatment groups, patients who achieved an objective tumor response experienced the greatest maximum improvement, but patients with stable disease also experienced improvement. 6 Although improvement in disease-related symptoms and HRQL is clinically important, another potential benefit of therapy is to delay the worsening of these outcomes. Two recent publications examined the time to first worsening of symptoms (TWS) in patients with advanced NSCLC.…”