Department of Medicine, Queen Mary Hospital, Pokfulam, China.
J Chemother. 2020 Dec;32(8):429-436. doi: 10.1080/1120009X.2020.1829325. Epub 2020 Oct 12.
Maintenance chemotherapy was studied in first line setting for advanced stage non-small cell lung carcinoma (NSCLC). There has not been any data on the role of continuation maintenance chemotherapy in second line setting. A retrospective cohort study that included 226 patients with advanced stage NSCLC that received second line gemcitabine ± platinum was conducted. Patients who had continuation maintenance gemcitabine were compared with those who went on drug holiday. The primary endpoint was progression-free survival (PFS), counted from the end of induction therapy. The median PFS was significantly longer for patients who continued with maintenance gemcitabine when compared with those on drug holiday (5.6 vs 1.7 months, HR 0.392, p-value < 0.001). The overall survival was also significantly longer (21.4 vs 15.8 months, HR 0.508, p-value 0.047). There was no increase in incidence of adverse events for patients who underwent maintenance gemcitabine. Continuation maintenance therapy with gemcitabine in second line setting is a potentially feasible and safe option for patients with advanced NSCLC.
维持化疗在晚期非小细胞肺癌（NSCLC）的一线治疗中得到了研究。在二线治疗中，延续维持化疗的作用尚无相关数据。进行了一项回顾性队列研究，纳入了 226 名接受二线吉西他滨±铂类药物治疗的晚期 NSCLC 患者。比较了继续接受维持吉西他滨治疗的患者与停止药物治疗的患者。主要终点是从诱导治疗结束开始计算的无进展生存期（PFS）。与停药的患者相比，继续接受维持吉西他滨治疗的患者的中位 PFS 明显更长（5.6 与 1.7 个月，HR 0.392，p 值<0.001）。总生存期也明显更长（21.4 与 15.8 个月，HR 0.508，p 值 0.047）。接受维持吉西他滨治疗的患者不良事件发生率没有增加。对于晚期 NSCLC 患者，二线治疗中继续使用吉西他滨维持治疗是一种可行且安全的选择。
