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1、IIclnical practice guidelines-non-smalbcell lung cancer (NSCLC): ESMO Ctnlcal Practice Guidelines for diagnosis, treatment and followHip1M W.& 比3.M RomuZo B艮M 如 & Pt5 & 0Abricf twr?O ucewigtrq 5q if _7 iHUI MM W I ” ”*( fa d ME VW.Mi MMl 4 bM 4m b VMMM Aw ta * MT M MM+* .4w* Abt* evMaeW w * tew * *M

2、 _ IRK4 FWT *T aam ftv UM IMlOUmb to 0 Cam CmM OBOO wwB AW r *W k w m usteT (K J AU flK Mrf awaa tow (Wm MrfIBKVT.oBMev mAMbv WAntf. W e mcu MM4 0 HZ (1 al tatf teMf*A* H ii*r AU Wa 7 sw ”& AflMa J Mw e 鼻科 qy* M 4 m w k *- wml J 4 AV Ul| n ww MfeVrfRflWv8 $1EAnn als of On cology cli ni cal practice

3、guideli nes Table 4. Levels of evide nee and grades of recomme ndatio n (adapted from the In fectious Diseases Society of America- United States Public Health Service Grading Systema Levels of evidence I II III IV V Evide nce from at least one large ran domised, con trolled trial of good methodologi

4、cal quality (low pote ntial for bias or meta-a nalyses of wellc on ducted ran domised trials without heteroge neity Small ran domised trials or large ran domised trials with a suspici on of bias (lower methodological quality or meta-a nalyses of such trials or of trials with dem on strated heteroge

5、neity Prospective cohort studies Retrospective cohort studies or case-c on trol studies Studies without con trol group, case reports, experts opinions Grades of recommendation A B C D E a Strong evidence for efficacy with a substantial clinical ben efit, stron gly recomme nded Strong or moderate evi

6、de nce for efficacy but with a limited cli ni cal ben efit, gen erally recomme nded In sufficie nt evide nce for efficacy or ben efit does not outweigh the risk or the disadva ntages (adverse eve nts, costs, opti onal Moderate evide nce aga inst efficacy or for adverse outcome, gen erally not recomm

7、e nded Strong evide nce aga inst efficacy or for adverse outcome, n ever recomme nded Downl oaded from http:/a nnon / by guest on August 13, 2014 By permissi on of the In fectious Diseases Society of America 74. Squibb. KK has reported: speakersO bureau: Abbott Diagnostics, Roche

8、, AstraZeneca, Eli Lilly, P?zer. SP has reported: con sulta ncy/hono raria: Roche, Eli Lilly, AstraZe neca, P?zer, Boehri nger In gelheim, Bristol-Myers Squibb, Merck Serono, Daiichi San kyo, Tesaro. DDR has declared no potential con?icts of interest. references 1. Jemal A, Bray F, Center MM et a l

9、Global cancer statistics. CA Cancer J Clin 2011; 61: 6990. 2. Field JK, Oudkerk M, Pederse n JH, Duffy SW. Prospects for populati on scree ning and diag no sis of lung can cer. Lancet 2013; 382: 732-741.3. Malvezzi M, Bertuccio P, Levi F et al. European cancer mortality predictions for the year 2012

10、. Ann Oncol 2012; 23: 1044-052. 4. International Age ncy for Research on Can cer (IARC. http:/www.iarc.fr/ (23 May 2014, date last accessed. 5. Malvezzi M, Bertuccio P, Levi F et al. Europea n can cer mortality predicti ons for the year 2013. Ann On col 2013; 24: 792-800. 6. Wakelee HA, Cha ng ET, G

11、omez SL et al. Lung can cer in cide nee in n ever smokers. J Cli n On col 2007; 25: 472178. 7. Edwards BK, Brown ML, Wingo PA et al. Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 2005; 97: 1407-427. 8. Toh CK

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13、ety: international multidisciplinary classi?cation of lung adenocarcinoma: executive summary. Proc Am Thorac Soc 2011; 8: 381-385. 10. Sequist LV, Waltman BA, Dias-Santagata D et al. Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med 2011; 3:

14、 75ra26. 11. Kerr KM, Bubendorf L, Edelman MJ et al. 2nd ESMO Consen sus Conference on Lung Can cer: pathology and molecular biomarkers for non-small-cell I ung can cer. Ann On col 2014 June 17 epub ahead of prin t, doi:10.1093/a nnon c/mdu145. 12. Besse B, Adjei A, Baas P et al. 2nd ESMO Consen sus

15、 Conference on Lung Can cer: non-smalbell I ung can cer ?rst-li ne/sec ond and further lines of treatme nt in adva need disease. Ann Oncol 2014; 25: 147484. 13. Rekhtman N, Paik PK, Arcila ME et al. Clarifyi ng the spectrum of driver on coge ne mutatio ns in biomarker-veri?ed squamous carc inoma of

16、lung: lack of EGFR/KRAS and prese nce of PIK3CA/AKT1 mutatio ns. Clin Ca ncer Res 2012; 18: 1167 176. 14. Kwak EL, Bang YJ, Camidge DR et al. An aplastic lymphoma kin ase in hibiti on in non-small-cell l ung cancer. N En gl J Med 2010; 363: 1693703. 15. Shaw AT, Yeap BY, Min o-Ke nu dson M et al. Cl

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18、non-small-cell l ung cancer patients. I nt J Cancer 2013; 132: E37E47. 17. Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1. Eur J Cancer 2009; 45: 228247. 18. Baser S, Shannon VR, EapenGA et al. Smok ing cessati on

19、 after diag no sis of lung can cer is associated with a ben e?cial effect on performanee status. Chest 2006; 130: 178-790. 19. Hughes AN, O Brien ME, Petty WJ et al. Overcomi ng CYP1A1/1A2 mediated in duction of metabolism by escalat ing erlot inib dose in curre nt smokers. J Clin On col 2009; 27: 1

20、2201226. 20. Park JO, Kim SW, Ahn JS et al. Phase III trial of two versus four additional cycles in patients who are non progressive after two cycles of plat inu m-based chemotherapy in non smallcell lu ng cancer. J Clin Oncol 2007; 25: 5233-5239. 21. Schiller JH, Harri ngton D, Bela ni CP et al. Co

21、mparis on of four chemotherapy regime ns for adva need non-small-cell lung cancer. N Engl J Med 2002; 346: 92-98. 22. Ardizzoni A, Boni L, Tiseo M et al. Cisplat in- versus carboplat in -based chemotherapy in ?rst ine treatme nt of adva need nonsmall-cell I ung can cer: an in dividual patie nt data

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23、on Pawel J et al. Phase III study compari ng cisplat in plus gemcitab ine with cisplati n plus pemetrexed in chemotherapy-n aive patie nts with adva need-stage non-small-cell l ung can cer. J Cli n On col 2008; 26: 35432551. doi:10.1093/a nnon c/md99 |gLcli nical practice guideli nes 25. Scagliotti

24、G, Hanna N, Fossella F et al. The differe ntial ef?cacy of pemetrexed accord ing to NSCLC histology: a review of two phase III studies. Oncologist 2009; 14: 25363. 26. Ciuleanu T, Brodowicz T, Zielinski C et al. Maintenance pemetrexed plus best supportive care versus placebo plus best supportive car

25、e for non-small-cell l ung can cer: a ran domised, double-bli nd, phase 3 study. Lan cet 2009; 374: 1432-1440. 27. Sa ndler A, Gray R, Perry MC et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell l ung can cer. N Engl J Med 2006; 355: 2542 -2550. 28. Zhou C, Che n G, Liu X et

26、al. A ran domized, double-bli nd, placebo con trolled, multice ntre, phase III study of ?rst-li ne carboplat in/paclitaxel (CP plus bevacizumab(Bv or placebo (Pl in Chin ese patie nts with adva need or recurre nt non- squamous non-small cell l ung can cer (NSCLC. J Thorac On col 2013; 8(suppl 2: (ab

27、strMO06.13. 29. Lima AB, Macedo LT, Sasse AD. Additi on of bevacizumab to chemotherapy in adva need non-small cell l ung can cer: a systematic review and metaanalysis. PLoS One 2011; 6: e22681.30. Soria JC, Mauguen A, Reck M et al. Systematic review and meta-a nalysis of ran domised, phase ll/lll tr

28、ials add ing bevacizumab to plat inu m-based chemotherapy as ?rsNne treatme nt in patie nts with adva need non-smallcell lu ng cancer. Ann Oncol 2013; 24: 20430. 31. Pujol JL, Barlesi F, Daures JP. Should chemotherapy comb in ati ons for adva need non-small cell l ung can cer be plati nu m-based? A

29、meta-analysis of phase lll randomized trials. Lung Cancer 2006; 51: 335345. 32. Gridelli C, Ardizz oni A, Le Chevalier T et al. Treatme nt of adva need non-small-cell l ung can cer patie nts with ECOG performa nee status 2: results of an Europea n Experts Pan el. Ann On col 2004; 15: 419 426. 33. Gr

30、idelli C. Effects of vi norelbi ne on quality of life and survival of elderly patients with advaneed non-small-cell lung cancer. The Elderly Lung Can cer Vi no relbi ne ltalian Study Group. J Natl Ca neer lnst 1999; 91: 6672. 34.Lile nbaum R, Villa?or VM, Lan ger C et al. Sin gle -age nt versus comb

31、 in ati on chemotherapy in patie nts with adva need non-small cell l ung can cer and a performa nee status of 2: prog no stic factors and treatme nt selectio n based on two large ran domized clinical trials. J Thorac Oncol 2009; 4: 869-874. 35. Quoix E, Zalcman G, Oster JP et al. Carboplati n and we

32、ekly paclitaxel doublet chemotherapy compared with mono therapy in elderly patie nts with adva need non small-cell l ung can cer: lFCT-0501 ran domised, phase 3 trial. Lancet 2011; 378: 1079-088. 36. Zukin M, Barrios CH, Pereira JR et al.Ran domized phase lll trial of sin gle-age nt pemetrexed versu

33、s carboplat in and pemetrexed in patie nts with adva need non small-cell l ung can cer and Easter n Cooperative On cology Group performa nee status of 2. J Clin Oncol 2013; 31: 28492853. 37. Gridelli C, Perrone F, Gallo C et al. Chemotherapy for elderly patients with advaneed non-small-cell lung can

34、cer: the Multicenter ltalian Lung Cancer in the Elderly Study (MlLES phase lll ran domized trial. J Natl Ca neer lnst 2003; 95: 362-372. 38. Lee CK, Brow n C, Gralla RJ et al. lmpact of EGFR in hibitor in non-small cell lu ng can cer on progressi on-free a nd overall survival: a meta-analysis. J Nat

35、l Caneer lnst 2013; 105: 595605. 39. Mok TS,Wu YL, Thongprasert S et al. Ge?tinib or carboplatinpaclitaxel in pulmonaryade no carci noma. N Engl J Med 2009; 361: 947957. 40. Rosell R, Carceremy E, Gervais R et al. Erlot in ib versus sta ndard chemotherapy as ?rstne treatme nt for Europea n patie nts

36、 with adva need EGFR mutati on-positive non-small-cell l ung can cer (EURTAC: a multice ntre, ope n-label, ran domised phase 3 trial. La ncet On col 2012; 13: 239246. 41. Ya ng JC, Hirsh V, Schuler M et al. Symptom con trol a nd quality of life in LUXLu ng 3: a phase III study of afat inib or cispla

37、t in/pemetrexed in patie nts with adva need lung ade no carci noma with EGFR mutatio ns. J Clin Oncol 2013; 31: 33423350. 42. Lee SM, Khan I, Upadhyay S et al. First-line erlotinib in patients with advaneed non-small-cell lung can cer un suitable for chemotherapy (TOPICAL: a doublebli nd, placebo-co

38、 ntrolled, phase 3 trial. La ncet Oncol 2012; 13: 1161-170. 43. Gridelli C, Ciardiello F, Gallo C et al. First-li ne erlot inib followed by sec on d-l ine cisplati n-gemcitab ine chemotherapy in adva need non-small-cell l ung can cer: the TORCH ran domized trial. J Cli n On col 2012; 30: 300243011.

39、Ann als of On cology 44. Shaw AT, Yeap BY, Solo mon BJ et al. Effect of crizotinib on overall survival in patients with advaneed non-small-cell lung cancer harbouri ng ALK gene rearra ngeme nt: a retrospective an alysis. Lan cet On col 2011; 12: 1004-1012. 45. Cap puzzo F, Ciulea nu T, Stelmakh L et

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41、can cer: a systematic review and metaa nalysis. Chest 2011; 140: 11126.47. Paz-Ares LG, de Mari nis F, Dediu M et al. PARAMOUNT: ?n al overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after in duct ion treatme nt with pemetrexed plus cisplat in for

42、 adva need non squamous nonsmall-cell lu ng cancer. J Clin Oncol 2013; 31: 2895-2902. 48. Barlesi F, Scherpereel A, Rittmeyer A et al. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after ?rs-li ne in ducti on with bevacizumab, cisplati n, and pemetrexed in adva nee

43、d non squamous non-small-cell l ung can cer: AVAPERL(MO22089. J Clin Oncol 2013; 31: 3004011.49. Rittmeyer A, Scherpereel A, Gorbunova VA et al. Effect of maintenance bevacizumab (Bev plus pemetrexed (Pem after ?rst-li ne cisplat in/Pem/Bev in adva need non squamous non-small cell l ung can cer (n s

44、NSCLC on overall survival (OS of patie nts ( pts on the AVAPERL (MO22089 phase III randomized trial. J Clin Oncol 2013; 31(suppl: (abstr 8014. 50. Di Maio M, Chiodini P, Georgoulias V et al. Meta-a nalysis of sin gle-age nt chemotherapy compared with comb in ati on chemotherapy as sec on d-li ne tre

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