Cisplatin-based doublet chemotherapy is commonly used in NSCLC patients after surgery, but its impact on survival is limited and it has severe adverse reactions, such as myelosuppression
December 4, 2021
Cisplatin-based doublet chemotherapy is commonly used in NSCLC patients after surgery, but its impact on survival is limited and it has severe adverse reactions, such as myelosuppression. lung cancer (SCLC) is usually platinum with Etoposide (PE). Amrubicin provides comparable survival compared with the PE regimen with an acceptable toxicity profile in extensive stage SCLC patients. Supportive care, such as traditional Chinese medicine and pegylated filgrastim, play an important role in improving patients’ quality of life. 24%.38 In patients with non-squamous histology, the albumin-bound paclitaxel plus carboplatin and the solvent-based paclitaxel groups had similar ORR.38 Patients over 70 years old in the albumin-bound paclitaxel group showed significantly increased OS those in the solvent-based paclitaxel group.38 Albumin-bound paclitaxel resulted in significantly less sensory neuropathy and neutropenia, but more thrombocytopenia and anemia compared with solvent-based paclitaxel.38 Nab-paclitaxel plus carboplatin was approved for advanced NSCLC treatment in 2012 by the United States Food and Drug Administration, but has not yet been Vilanterol trifenatate approved by the CFDA. S-1, an oral fluoropyrimidine agent, yielded a response rate of 22% and a median OS of 10.2 months in advanced NSCLC patients without prior chemotherapy.39 Japanese researchers conducted a randomized phase III trial and found that the PFS and OS rates were similar between S-1 plus cisplatin and docetaxel plus cisplatin groups.40 A significantly lower rate of neutropenia and infection were observed in the S-1 plus cisplatin group.40 Compared with 10.55 months of carboplatin plus paclitaxel, carboplatin plus oral S-1 resulted in a median OS of 14.0 months and better tolerance in chemotherapy-naive patients with advanced squamous cell lung cancer.41 The results of an efficacy and safety analysis from a phase III, multi-center, parallel controlled clinical trial of docetaxel plus cisplatin versus S-1 plus cisplatin as first-line therapy in Chinese advanced NSCLC patients (SC-103 study; JapicCTI-111479) will be published soon. Vilanterol trifenatate The EAST study (JapicCTI-101155) is now recruiting participants with advanced NSCLC after failure of at least one prior platinum-based regiment. This randomized, controlled, multicenter, open-labeled, phase III clinical trial is aimed at establishing the non-inferiority of S-1 to docetaxel monotherapy in OS. Angiogenesis inhibitors have definite therapeutic effects on NSCLC; however, there is a need for biomarkers that could prospectively identify the Vilanterol trifenatate patients who would benefit most. Recombinant human endostatin (Endostar) was developed by the Chinese pharmaceutical industry with promising antiangiogenic and antitumor effects. Results of clinical trials have confirmed the improvement of survival Rabbit Polyclonal to Thyroid Hormone Receptor alpha Vilanterol trifenatate in Chinese advanced NSCLC patients after treatment of Endostar.42 Note that these studies did not consider EGFR mutation or ALK rearrangement status as exclusion criteria. In 2005, the CFDA approved endostar combined with cisplatin and vinorelbine as a regimen for stage III-IV NSCLC patients. Bevacizumab, a recombinant Vilanterol trifenatate monoclonal antibody that blocks the vascular endothelial growth factor, is one of the treatment options for NSCLC in combination with chemotherapy. However, the CFDA have not yet approved bevacizumab for lung cancer treatment. Adjuvant therapy in non-small cell lung cancer (NSCLC) patients Most clinical guidelines recommend adjuvant chemotherapy for NSCLC patients with stage II-III disease. Cisplatin-based doublet chemotherapy is commonly used in NSCLC patients after surgery, but its impact on survival is limited and it has severe adverse reactions, such as myelosuppression. Recently, the TREAT trial found that, compared with cisplatin plus vinorelbine, adjuvant chemotherapy with four cycles of cisplatin plus pemetrexed had significantly less hematological toxic effects and superior dose delivery.43 Targeted therapies, especially EGFR-TKIs, are now being assessed in the adjuvant setting. As a randomized phase III clinical trial, the BR19 study exhibited no disease-free survival (DFS) or OS benefit from gefitinib in completely resected stage IB-IIIA NSCLC patients, and even in patients with sensitive EGFR mutations.44 However, because of the small number of patients with sensitive EGFR mutations in the cohort, the results do not adequately reveal the effects for mutation-positive patients. Ongoing adjuvant studies of EGFR-TKIs.