IV期非小細胞肺癌に対する治療戦略維持療法

摘要

Purpose, Maintenance therapy has become a new paradigm of treatment for advanced non-small cell lung cancer (NSCLC), and several clinical trials of maintenance regimens have been reported. In this session, we reviewed recently updated data for these trials and clarified the standard maintenance therapy regimen for advanced NSCLC. Results. The updated overall survival (OS) results of the AVAPERL study, which evaluated cisplatin-pemetrexed (PEM)-bevacizumab (Bev) followed by maintenance PEM and Bev did not show any significant survival benefits for this regimen against cisplatin-PEM-Bev (HR 0.88, 95% CI: 0.64-1.22, p = 0.32). The PointBreak study, which compared carboplatin-PEM-Bev followed by maintenance Bev and PEM to car-boplatin + paclitaxel+ Bev did not meet the primary endpoint of OS, although the progression free survival (PFS) was significantly prolonged. In addition, the PRONOUNCE study was unable to demonstrate the superiority of carboplatin-PEM followed by maintenance PEM over carboplatin + paclitaxel+ Bev in terms of PFS without Grade 4 adverse events. Conclusions. The results of recent clinical trials are not adequate to change the standard regimen of maintenance therapy for advanced NSCLC.しisplatin-PEM followed by maintenance PEM or carboplatin + paclitaxel+ Bev remains the standard regimen