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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
Tuesday, August 9, 2011
Tuesday, August 9, 2011
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
Tuesday, August 9, 2011
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
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
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
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.
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011
Tuesday, August 9, 2011

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Nsclc 2nd line