Fourth-line and Beyond Therapy in Advanced Non-small Cell Lung Cancer:A Retrospective Analysis
10.3779/j.issn.1009-3419.2014.12.03
- VernacularTitle:晚期非小细胞肺癌探索性四线及以上治疗的回顾性分析
- Author:
WANG XIANFENG
1
;
HUANG MEIJUAN
;
REN LI
;
XU YONG
;
LI LU
;
HOU MEI
;
WANG JIN
;
PENG FENG
;
ZHU JIANG
;
WANG YONGSHENG
;
LU YOU
Author Information
1. 四川大学华西医院肿瘤中心胸部肿瘤科
- Keywords:
Lung neoplasms;
Fourth-line therapy;
Survival and prognostic factors
- From:
Chinese Journal of Lung Cancer
2014;(12):839-844
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectiveA common consensus has been reached regarding ifrst- and second-line therapies for advanced non-small cell lung cancer (NSCLC). The newest guideline from National Comprehensive Cancer Network (NCCN) also provides recommendations for third-line therapy. This study focused on fourth-line and enhanced treatments for advanced NSCLC. Treatment results and impact factors were analyzed and discussed.MethodsA total of 140 patients with advanced NSCLC were selected and their data were analyzed. Response rate, survival rate, and prognostic factors were evaluated.Results Among the 140 patients, 12.9% (18 cases) showed partial response, 25.7% (36 cases) suffered from a stable disease, and 38.6% (54 cases) exhibited a disease control rate. Median overall survival (OS) and fourth-line therapy OS were 31 months and 10.1 months, respectively. The median progression free survival (PFS) of fourth-line therapy was 2.6 months. Univariate and multivariate analyses indicated different therapy regimens and suggested whether or not patients should undergo follow-up treatments. These parameters were independent prognostic factors of the OS of the fourth-line therapy; by contrast, no independent impact factor of PFS was found. Chemotherapy resulted in better median OS in fourth-line therapy than in targeted therapy (11.7 monthsvs 7.1 months,P=0.013). Considering the median OS of fourth-line therapy, we observed that single agent therapy did not signiifcantly differ from double agent therapy; likewise, we found that ifrst-time usage did not signiifcantly differ from multiple usage of epidermal growth factor receptor tyrosine kinase inhibitor.Conclusion Fourth-line therapy is recommended to increase the survival of advanced NSCLC patients. Nevertheless, the role of fourth-line therapy in advanced NSCLC should be further assessed in clinical trials.
