Svaton Martin, Marel Miloslav, Venclicek Ondrej, Kultan Juraj, Cernovska Marketa, Hrnciarik Michal, Krejci Jana, Odrazka Karel, Domecky Petr
Department of Pneumology and Phthisiology, University Hospital in Pilsen, Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic.
Department of Pulmonology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Transl Cancer Res. 2025 Jul 30;14(7):4348-4356. doi: 10.21037/tcr-2024-2555. Epub 2025 Jul 22.
The efficacy of second-line chemotherapy with pemetrexed or docetaxel was evaluated in phase III clinical trials only after prior treatment with a platinum doublet in non-small cell lung cancer. The effectiveness of second-line chemotherapy after previous chemotherapy and immunotherapy is not well known. The effectiveness of third-line chemotherapy is not practically proven in this sense. The aim of this retrospective study was therefore to assess the effectiveness of second- and third-line chemotherapy in patients pretreated with chemotherapy with platinum doublet and immunotherapy based on retrospective data.
Patients from the Czech Lung Cancer Focus (LUCAS) lung cancer registry who were pretreated with chemotherapy and immunotherapy were evaluated. Time on treatment (ToT) and overall survival (OS) with second- and third-line chemotherapy were evaluated using Kaplan-Meier method.
One hundred and fourteen patients treated with second-line chemotherapy were evaluated. Their ToT reached a median of 2.9 [95% confidence interval (CI): 2.4-4.7] months and OS a median of 7.2 (95% CI: 6.1-11.2) months. Twenty-two patients treated with third-line chemotherapy were evaluated. Their ToT reached a median of 5.1 (95% CI: 1.4-NA) months and OS a median of 13.8 (95% CI: 6.1-NA) months.
The efficacy of second-line chemotherapy in our group of patients (pretreated with chemotherapy and immunotherapy) was comparable with registration studies for second-line chemotherapy. In a selected population, even third-line chemotherapy can be effective.
培美曲塞或多西他赛二线化疗的疗效仅在非小细胞肺癌患者接受铂类双药联合一线治疗后进行的III期临床试验中得到评估。先前化疗和免疫治疗后二线化疗的有效性尚不清楚。从这个意义上讲，三线化疗的有效性尚未得到实际验证。因此，这项回顾性研究的目的是基于回顾性数据评估接受铂类双药联合化疗和免疫治疗预处理的患者二线和三线化疗的有效性。
对来自捷克肺癌聚焦（LUCAS）肺癌登记处且接受过化疗和免疫治疗预处理的患者进行评估。采用Kaplan-Meier法评估二线和三线化疗的治疗时间（ToT）和总生存期（OS）。
对114例接受二线化疗的患者进行了评估。他们的ToT中位数为2.9[95%置信区间（CI）：2.4 - 4.7]个月，OS中位数为7.2（95%CI：6.1 - 11.2）个月。对22例接受三线化疗的患者进行了评估。他们的ToT中位数为5.1（95%CI：1.4 - NA）个月，OS中位数为13.8（95%CI：6.1 - NA）个月。
我们这组患者（接受过化疗和免疫治疗预处理）二线化疗的疗效与二线化疗的注册研究相当。在特定人群中，甚至三线化疗也可能有效。
