Maintenance treatment of advanced non-small-cell lung cancer: Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology

Cesare Gridelli, Filippo de Marinis, Massimo Di Maio, Andrea Ardizzoni, Chandra Belani, Federico Cappuzzo, Fortunato Ciardiello, Panagiotis Fidias, Luis Paz-Ares, Francesco Perrone, Robert Pirker, Luigi De Petris, Rolf Stahel

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Several randomized trials have recently investigated the role of maintenance treatment for patients with advanced non-small-cell lung cancer (NSCLC) with responding or stable disease after completion of first-line chemotherapy. Maintenance strategy has relevant implications in terms of potential toxicity, logistics and costs, and all of these aspects should be taken into account, together with the magnitude of benefit for the patient. In order to assess the strengths and limitations of available evidence, to help clinical practice, and to suggest priorities for future clinical research, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting on maintenance treatment of advanced NSCLC, which took place in Sperlonga (Italy) in May 2011. Based on the available evidence, panelists agreed that maintenance therapy represents a treatment option in advanced NSCLC. Maintenance should be discussed with patients not progressed after 4-6 cycles of first-line chemotherapy, who are fit (performance status 0-1) and without persistent chemotherapy-induced toxicity. Patients need to be well informed about potential advantages and disadvantages of accepting additional therapy without a "treatment-free period" Two different strategies, switch or continuation maintenance, are supported by available evidence. At the moment, there is no direct comparison between switch maintenance and continuation maintenance. For future trials, the panel recommends the use of overall survival as the primary endpoint, with pre-defined second-line treatment. Translational research is essential to identify predictive factors, and should be performed, whenever feasible, in order to achieve treatment optimization with proper patient selection.

Original languageEnglish (US)
Pages (from-to)269-279
Number of pages11
JournalLung Cancer
Volume76
Issue number3
DOIs
StatePublished - Jun 1 2012

Fingerprint

Non-Small Cell Lung Carcinoma
Thorax
Maintenance
Therapeutics
Drug Therapy
Translational Medical Research
Patient Selection
Italy
Costs and Cost Analysis
Survival
Research

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Gridelli, Cesare ; de Marinis, Filippo ; Di Maio, Massimo ; Ardizzoni, Andrea ; Belani, Chandra ; Cappuzzo, Federico ; Ciardiello, Fortunato ; Fidias, Panagiotis ; Paz-Ares, Luis ; Perrone, Francesco ; Pirker, Robert ; De Petris, Luigi ; Stahel, Rolf. / Maintenance treatment of advanced non-small-cell lung cancer : Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology. In: Lung Cancer. 2012 ; Vol. 76, No. 3. pp. 269-279.
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abstract = "Several randomized trials have recently investigated the role of maintenance treatment for patients with advanced non-small-cell lung cancer (NSCLC) with responding or stable disease after completion of first-line chemotherapy. Maintenance strategy has relevant implications in terms of potential toxicity, logistics and costs, and all of these aspects should be taken into account, together with the magnitude of benefit for the patient. In order to assess the strengths and limitations of available evidence, to help clinical practice, and to suggest priorities for future clinical research, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting on maintenance treatment of advanced NSCLC, which took place in Sperlonga (Italy) in May 2011. Based on the available evidence, panelists agreed that maintenance therapy represents a treatment option in advanced NSCLC. Maintenance should be discussed with patients not progressed after 4-6 cycles of first-line chemotherapy, who are fit (performance status 0-1) and without persistent chemotherapy-induced toxicity. Patients need to be well informed about potential advantages and disadvantages of accepting additional therapy without a {"}treatment-free period{"} Two different strategies, switch or continuation maintenance, are supported by available evidence. At the moment, there is no direct comparison between switch maintenance and continuation maintenance. For future trials, the panel recommends the use of overall survival as the primary endpoint, with pre-defined second-line treatment. Translational research is essential to identify predictive factors, and should be performed, whenever feasible, in order to achieve treatment optimization with proper patient selection.",
author = "Cesare Gridelli and {de Marinis}, Filippo and {Di Maio}, Massimo and Andrea Ardizzoni and Chandra Belani and Federico Cappuzzo and Fortunato Ciardiello and Panagiotis Fidias and Luis Paz-Ares and Francesco Perrone and Robert Pirker and {De Petris}, Luigi and Rolf Stahel",
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Gridelli, C, de Marinis, F, Di Maio, M, Ardizzoni, A, Belani, C, Cappuzzo, F, Ciardiello, F, Fidias, P, Paz-Ares, L, Perrone, F, Pirker, R, De Petris, L & Stahel, R 2012, 'Maintenance treatment of advanced non-small-cell lung cancer: Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology', Lung Cancer, vol. 76, no. 3, pp. 269-279. https://doi.org/10.1016/j.lungcan.2011.12.011

Maintenance treatment of advanced non-small-cell lung cancer : Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology. / Gridelli, Cesare; de Marinis, Filippo; Di Maio, Massimo; Ardizzoni, Andrea; Belani, Chandra; Cappuzzo, Federico; Ciardiello, Fortunato; Fidias, Panagiotis; Paz-Ares, Luis; Perrone, Francesco; Pirker, Robert; De Petris, Luigi; Stahel, Rolf.

In: Lung Cancer, Vol. 76, No. 3, 01.06.2012, p. 269-279.

Research output: Contribution to journalReview article

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T1 - Maintenance treatment of advanced non-small-cell lung cancer

T2 - Results of an International Expert Panel Meeting of the Italian Association of Thoracic Oncology

AU - Gridelli, Cesare

AU - de Marinis, Filippo

AU - Di Maio, Massimo

AU - Ardizzoni, Andrea

AU - Belani, Chandra

AU - Cappuzzo, Federico

AU - Ciardiello, Fortunato

AU - Fidias, Panagiotis

AU - Paz-Ares, Luis

AU - Perrone, Francesco

AU - Pirker, Robert

AU - De Petris, Luigi

AU - Stahel, Rolf

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Several randomized trials have recently investigated the role of maintenance treatment for patients with advanced non-small-cell lung cancer (NSCLC) with responding or stable disease after completion of first-line chemotherapy. Maintenance strategy has relevant implications in terms of potential toxicity, logistics and costs, and all of these aspects should be taken into account, together with the magnitude of benefit for the patient. In order to assess the strengths and limitations of available evidence, to help clinical practice, and to suggest priorities for future clinical research, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting on maintenance treatment of advanced NSCLC, which took place in Sperlonga (Italy) in May 2011. Based on the available evidence, panelists agreed that maintenance therapy represents a treatment option in advanced NSCLC. Maintenance should be discussed with patients not progressed after 4-6 cycles of first-line chemotherapy, who are fit (performance status 0-1) and without persistent chemotherapy-induced toxicity. Patients need to be well informed about potential advantages and disadvantages of accepting additional therapy without a "treatment-free period" Two different strategies, switch or continuation maintenance, are supported by available evidence. At the moment, there is no direct comparison between switch maintenance and continuation maintenance. For future trials, the panel recommends the use of overall survival as the primary endpoint, with pre-defined second-line treatment. Translational research is essential to identify predictive factors, and should be performed, whenever feasible, in order to achieve treatment optimization with proper patient selection.

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