2011 Focused Update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer
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...However, that study was not powered to assess a difference in OS....
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...Current treatment guidelines for patients with advanced NSCLC recommend four to six cycles of a platinum-based doublet as first-line or induction treatment.(11,12) PARAMOUNT specified four cycles of induction therapy, modeled after other recent maintenance trials(1,3-5) and because evidence suggested this was an acceptable duration....
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...Another recent phase III study by Pérol et al5 also found that gemcitabine continuation maintenance delivered a PFS benefit but not improvement in OS....
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...Previous studies have demonstrated that switch maintenance affects OS.12,26 Indeed, a recent meta-analysis that included 4,286 patients found superior efficacy of the switch maintenance strategy.27 Although PFS was statistically significant for both switch maintenance (HR, 0.62) and continuation maintenance (HR, 0.90), OS was signif- icantly improved in the switch analysis only (HR, 0.84; P .00026 v HR, 0.92; P .33)....
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...Previous studies have demonstrated that switch maintenance affects OS.(12,26) Indeed, a recent meta-analysis that included 4,286 patients found superior efficacy of the switch maintenance strategy....
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