American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

• DOI: 10.1200/jco.2009.23.5622
• Publication Date: 2009-11-17T03:09:05Z
• Authors: Christopher G. Az...; Sherman Baker; Sarah Temin; William Pao; Timothy Aliff; Julie Brahmer; David H. Johnson; Janessa L. Laskin; Gregory Masters; Daniel Milton; Luke Nordquist; David G. Pfister; Steven Piantadosi; Joan H. Schiller; Reily Smith; Thomas J. Smith; John R. Strawn; David Trent; Giuseppe Giaccone
• Keywords: Pemetrexed; Vinorelbine; Carboplatin; Targeted Therapy; Performance status

The purpose of this article is to provide updated recommendations for the treatment patients with stage IV non-small-cell lung cancer. A literature search identified relevant randomized trials published since 2002. scope guideline was narrowed chemotherapy and biologic therapy. An Update Committee reviewed made recommendations. One hundred sixty-two publications met inclusion criteria. Recommendations were based on strategies that improve overall survival. Treatments only progression-free survival prompted scrutiny toxicity quality life. For first-line therapy in performance status 0 or 1, a platinum-based two-drug combination cytotoxic drugs recommended. Nonplatinum doublets are acceptable contraindications platinum 2, single drug sufficient. Stop at disease progression after four cycles who not responding treatment. six even use gefitinib may be recommended known epidermal growth factor receptor (EGFR) mutation; negative unknown EGFR mutation status, preferred. Bevacizumab carboplatin-paclitaxel, except certain clinical characteristics. Cetuximab cisplatin-vinorelbine EGFR-positive tumors by immunohistochemistry. Docetaxel, erlotinib, gefitinib, pemetrexed as second-line Erlotinib third-line have received prior erlotinib gefitinib. Data insufficient recommend routine drugs. molecular markers select chemotherapy.