Chest
Original ResearchLung CancerSecond-Line Treatments in Non-small Cell Lung Cancer: A Systematic Review of Literature and Metaanalysis of Randomized Clinical Trials
Section snippets
Search Criteria and Systematic Review of Literature
A systematic review of MEDLINE, EMBASE, CINAHL, CRISP, and Cochrane Systematic Reviews databases from January 2000 to July 2008 was independently performed by two authors (D.T. and L.L.A.), using “Carcinoma, Non Small-Cell Lung” (medical subject heading [MeSH] term) and “Drug Therapy” (MeSH term) and “docetaxel” (MeSH term) or “erlotinib” (MeSH term) or “gefitinib” (MeSH term) as search terms. A primary analysis was planned to compare the outcomes of antineoplastic treatments vs BSC, and a
Literature Review
We retrieved and examined 336 descriptive reviews, 104 clinical trials, and 8 systematic reviews with metaanalysis in the preliminary evaluation. Fifteen of these 448 articles (all of them reporting data of randomized phase III clinical trials) were considered potentially eligible because they reported mature data comparing different therapeutic options in second-line treatment of NSCLC, and 14 were included into the analysis. Two of the 15 potentially eligible studies3, 19 reported data from
Discussion
In the last few years, many authors have investigated the role of second-line therapies in advanced NSCLC,14, 15, 25, 26, 27 and different options were recommended by the primary scientific societies as the “gold standard.”1, 2, 4, 5 Based on these recommendations, docetaxel or pemetrexed represent the main chemotherapeutic options, and erlotinib is the biological alternative to chemotherapy, mainly in no-smoker females with adenocarcinoma.14, 15, 25, 26, 27 However, some issues remain
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