Nsclc 2nd line

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

Weekly vs 3-weekly
Docetaxel
Overall
survival
(OAS) curves
by treatment
arm.

Individual Patient
Data Meta-Analysis
of Docetaxel
Administered Once
Every 3 Weeks
Compared With
Once
Every Week Second-
Line Treatment of
Advanced Non–
Small-Cell Lung
Cancer Di Maio
Tuesday, August 9, 2011 J.Clin. Oncol.

Weekly vs 3-weekly
Docetaxel
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
Once
Every Week Second-
Line Treatment of
Advanced Non–
Small-Cell Lung
Cancer Di Maio
Tuesday, August 9, 2011 J.Clin. Oncol.

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

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

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 v
docetaxel, 2.9
months (HR,Beneﬁt0.72;
Elderly Patients
From Second-Line
Cytotoxic
Chemotherapy: A Subset
Analysis of a
Randomized PhaseIII
Trial of Pemetrexed
Compared With
Docetaxel in
Patients 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; Patients Beneﬁt
Elderly
From Second-Line
Cytotoxic
Chemotherapy: A Subset
Analysis of a
Randomized PhaseIII
Trial of Pemetrexed
Compared With
Docetaxel in
Patients With Previously
Treated Advanced Non–
Small-Cell Lung Cancer
Weiss G J.Clin. Oncol.
006;24:4405-11

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.

Nsclc 2nd line

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