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Second Line Treatment of metastatic Non-Small Cell Lung Cancer Update from the World Conference on Lung Cancer G. Nsouli MD Tuesday, August 9, 2011

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Second Line Treatment of metastatic Non-Small Cell

Lung Cancer

Update from the World Conference on Lung Cancer

G. Nsouli MD

Tuesday, August 9, 2011

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Weekly vs 3-weekly Docetaxel

Individual Patient Data Meta-Analysis of Docetaxel Administered Once Every 3 Weeks Compared With OnceEvery Week Second-Line Treatment of Advanced Non–Small-Cell Lung Cancer Di Maio J.Clin. Oncol.2007;25:1377-82

Overall survival (OAS) curves by treatment arm.

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Treatment effect on survival within major patient subgroups. PS,performance status.

Individual Patient Data Meta-Analysis of Docetaxel Administered Once Every 3 Weeks Compared With OnceEvery Week Second-Line Treatment of Advanced Non–Small-Cell Lung Cancer Di Maio J.Clin. Oncol.2007;25:1377-82

Weekly vs 3-weekly Docetaxel

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Pemetrexed vs. Docetaxel in second line

Randomized Phase III Trial of Pemetrexed Versus Docetaxel in Patients With Non–Small-Cell Lung CancerPreviously Treated With ChemotherapyJ. Clin. Oncol 2004; 22:1589-97

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Survival and Toxicity

Randomized Phase III Trial of Pemetrexed Versus Docetaxel in Patients With Non–Small-Cell Lung CancerPreviously Treated With ChemotherapyJ. Clin. Oncol 2004; 22:1589-97

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Elderly Patients Benefit From Second-Line CytotoxicChemotherapy: A Subset Analysis of a Randomized PhaseIII Trial of Pemetrexed Compared With Docetaxel inPatients With Previously Treated Advanced Non–Small-Cell Lung Cancer Weiss G J.Clin. Oncol. 006;24:4405-11

Median time to progression (A) for patients younger than 70 years of age:pemetrexed, 3.0 months v docetaxel, 3.9 months (hazard ratio [HR], 1.03; ; (B) for patients 70 years of age: pemetre-xed, 4.6 months vdocetaxel, 2.9 months (HR, 0.72;

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Elderly Patients Benefit From Second-Line CytotoxicChemotherapy: A Subset Analysis of a Randomized PhaseIII Trial of Pemetrexed Compared With Docetaxel inPatients With Previously Treated Advanced Non–Small-Cell Lung Cancer Weiss G J.Clin. Oncol. 006;24:4405-11

Median overall survival time (A) for patients younger than 70 years of age:pemetrexed, 7.8 months v docetaxel, 8.0 months HR], 1.02; (B) for patients 70 years of age: pemetrexed, 9.5 months v docetaxel, 7.7 months (HR, 0.86;

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Current Guidelines in Second line treatment of NSCLC

• For patients with disseminated metastatic disease, both second-line cytotoxic chemotherapy and small molecule epidermal growth factor receptor (EGFR) inhibitors may provide palliation and increase survival.

• When symptoms are due to progressive disease within the chest or from metastatic involvement of a single or limited number of sites, radiation therapy (RT) is often useful for palliation.

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