Non-Small Cell Lung Cancer non small cell lung cancerNCCN Guidelines Version 4.2016 NCCN guide 2016 edition fourthDiscussion discussionTreat
Non-Small Cell Lung Cancer non small cell lung cancer
NCCN Guidelines Version 4.2016 NCCN guide 2016 edition fourth
Treatment Approaches treatment
Targeted Therapies targeted therapy
Crizotinib crizotinib (Xalkori, Saikerui, Pfizer)
Crizotinib is approved by the FDA for patients with locally advanced or metastatic NSCLC who are positive for the ALK gene rearrangement. The approval is based on a phase trial that showed dramatic response rates 2 (> 80%) to crizotinib in patients who had previously progressed. Patients receiving crizotinib reported clinically significant improvements in pain, dyspnea and, cough. A recent phase 3 trial compared first-line crizotinib versus chemotherapy in patients with ALK rearrangements patients receiving crizotinib had improved; PFS quality, of life, and response rates when compared with those receiving chemotherapy. The NCCN Panel recommends first-line therapy with crizotinib (Category 1) based on this phase trial and the FDA appro 3 Val; the panel also feels that crizotinib is appropriate for patients with PS Crizotinib may also 0 to 4 be continued for patients with ALK rearrangements who have progressed if patients do not have multiple systemic symptomatic lesions. FDA approved crizotinib for ALK positive patients with locally advanced or metastatic NSCLC. The approval was based on a phase 2 trial that showed a dramatic response to a patient who had been in progress (+ 80%). Patients who received the drug reported significant improvement in pain, dyspnea and cough. In a recent phase 3 trial, PFS was compared with first-line chemotherapy in patients with ALK and chemotherapy, and compared with those receiving chemotherapy, the quality of life, and the rate of improvement were significantly higher in patients treated with erlotinib. Based on this phase 3 trial and the approval of NCCN, the FDA experts recommend first-line treatment with erlotinib (Class 1), and the team also believes that 0-4 is suitable for patients with PS. For patients with advanced ALK rearrangements, if the patient does not have multiple symptomatic lesions, the use of the drug may also be continued.