The Use of Systemic Treatment in the Maintenance of Patients with Non-Small Cell Lung Cancer

Guideline Objective

To make recommendations in the maintenance setting regarding the use of systemic treatment in the care of patients with non-small cell lung cancer (NSCLC).

Patient Population

Advanced, stage IIIB/IV patients who have NSCLC who have not progressed (i.e., complete response, partial response or stable disease) following four to six cycles of platinum-based chemotherapy and maintained an Eastern Cooperative Oncology Group performance status of 0 to 2.

Intended Guideline Users

Oncologists involved in the care of patients with NSCLC who require maintenance systemic treatment.

Research Question(s)

1. In patients with advanced NSCLC who have received initial first-line platinum-based chemotherapy for a minimum of four cycles, does maintenance systemic therapy improve overall survival (OS), progression-free survival (PFS), or quality of life in comparison with either placebo or second line therapy at the time of progression?
2. In patients with advanced NSCLC who have received initial first-line platinum-based chemotherapy for a minimum of four cycles, does any systemic therapy agent improve OS, PFS or quality of life in comparison with other systemic therapies?
3. In patients with advanced NSCLC, are there any clinical or molecular characteristics that identify subgroups of patients who derive greater benefit from maintenance systemic therapy?