1. Second Line Treatment of
metastatic Non-Small Cell
Lung Cancer
Update from the World
Conference on Lung Cancer
G. Nsouli MD
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5. 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.

6. 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.

7. 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
Tuesday, August 9, 2011

8. 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
Tuesday, August 9, 2011

9. 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
Tuesday, August 9, 2011

10. 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
Tuesday, August 9, 2011

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.
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