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Recurrent Non small Cell Lung Cancer

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Recurrent Non small Cell Lung Cancer PowerPoint Presentation

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Published on : Feb 24, 2014
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Slide 1 - The Need for 3rd-Line Therapy in Non-Small Cell Lung Cancer Frances A. Shepherd, MD Scott Taylor Chair in Lung Cancer ResearchPrincess Margaret Hospital Professor of Medicine, University of Toronto
Slide 2 - CRC-2 > 110,000 patientspotential candidates forsystemic therapy yearly Metastatic Resectable disease Locallyadvanced Most Patients With NSCLC Will Require Systemic Therapy ~80% relapse Shepherd. Semin Oncol. 1999. ~50% relapse
Slide 3 - CRC-3 Systemic Treatment for Advanced NSCLCChemotherapy — 1st-Line Modestly improves survival and symptoms Platinum-based regimens the standard Uncertain benefit in patients with PS 2 Toxicity an issue 1st- and 2nd-line
Slide 4 - CRC-4 2nd-Line Treatment for NSCLC Docetaxel is the only chemotherapy approved for NSCLC Response rate is low –— only 6% to 7% Demonstrated benefit in terms of survival and symptom control Toxicity is an issue
Slide 5 - CRC-5 3rd-Line Treatment for Advanced NSCLC For NSCLC, no standard definition for disease refractory to both platinum and docetaxel Clinical definition of 3rd-line: patients previously treated with a platinum and docetaxel who are not expected to benefit from additional treatment with same Single-agent chemotherapy now used for 3rd-line
Slide 6 - CRC-6 Massarelli et al. ASCO. 2002. Outcomes in NSCLC Patients From Startof 3rd- and 4th-Line Therapy Months after start of 3rd- or 4th-line therapy Survival probability 0 6 12 18 24 0.0 0.2 0.4 0.6 0.8 1.0 0.1 0.3 0.5 0.7 0.9 Objective response 2.3% (n = 1) Median survival 4.5 months 1-year survival 5% N = 43
Slide 7 - CRC-7 NSCLC Commonly Causes Disease-Related Symptoms Specific symptoms Shortness of breath Cough Tightness in the chest Difficulty breathing Poor Appetite and Weight loss Fatigue Type, severity, frequency depend on tumor location, disease burden, and growth rate
Slide 8 - CRC-8 Significance of Objective Responses in 3rd-Line Therapy of NSCLC Measure of antitumor activity Associated with symptom improvement Associated with better patient outcomes
Slide 9 - CRC-9 Disease-Related Symptoms in NSCLC When asked, 68% of patients with NSCLC who had already received platinum, stated they would choose chemotherapy compared to best supportive care if symptoms could be substantially reduced, even if survival was not prolonged Silvestri et al. 1998
Slide 10 - CRC-10 Goals of 3rd-Line Therapy in NSCLC Improve disease-related symptoms Improve performance status Treatment not an additional burden Enhanced patient control Holiday from IV therapy Less time away from home for treatment
Slide 11 - CRC-11 3rd-Line Therapy forNon-Small Cell Lung Cancer: an Unmet Need Increasing numbers of patients with NSCLC for 3rd-line therapy Most of these patients have significant disease-related symptoms No approved 3rd-line agents Standard chemotherapies a poor solution 3rd-line therapy for NSCLC represents an unmet medical need