Non-Small Cell Lung Cancer Treatment –for health professionals (PDQ®)

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Changes to This Summary (01/22/2016)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Stage IIIA Non-Small Cell Lung Cancer (NSCLC) Treatment

Revised text to state that in two small case series of 97 and 104 patients, respectively, the 5-year survival rates of patients who had completely resected T3, N0, M0 disease were 44.2% and 67.3%; for completely resected T3, N1, M0 disease, 5-year survival rates were 40.0% and 100.0%; and for completely resected T3, N2, M0 disease, 5-year survival rates were 6.2% and 17.9%.

Stage IV NSCLC Treatment

Added text about two phase II trials that evaluated the addition of necitumumab to platinum doublet chemotherapy in the first-line treatment of patients with advanced non-squamous and advanced squamous NSCLC (cited Paz-Ares et al. as reference 37 and Thatcher et al. as reference 38). In the SQUIRE trial, necitumumab was associated with higher grades 3 and 4 toxicities and a relatively modest benefit; in the INSPIRE trial, serious and grades 3 and 4 adverse events, including thromboembolic events, were higher in the necitumumab-containing arm; the incidence of treatment-related deaths was also higher.

Recurrent NSCLC Treatment

Revised the list of immunotherapy, chemotherapy, or kinase inhibitors alone for patients who have previously received platinum chemotherapy to include nivolumab for patients with metastatic NSCLC and pembrolizumab for patients with metastatic NSCLC whose tumors express PD-L1 (cited Garon et al. as reference 4).

Revised text to state that a randomized, open-label, phase III trial randomly assigned 272 advanced squamous NSCLC patients who had received one regimen of platinum-containing chemotherapy to receive either nivolumab 3 mg/kg every 2 weeks or docetaxel 75 mg/m2 every 3 weeks, administered until disease progression.

Revised text to state that a randomized, open-label, phase III trial randomly assigned 582 advanced non-squamous NSCLC patients who had received one regimen of platinum-containing chemotherapy to receive either nivolumab 3 mg/kg every 2 weeks or docetaxel 75 mg/m2 every 3 weeks, administered until disease progression (cited Borghaei et al. as reference 19).

Added text about a phase I study with multiple expansion cohorts in which pembrolizumab demonstrated significant activity with respect to response rate and duration of response (added level of evidence 3iiiDiv).

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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