Maintenance Chemotherapy Use for Advanced Non-Small Cell Lung Cancer in an Australian Cancer Centre

BACKGROUND: To investigate the rates of maintenance therapy in advanced non-small cell cancer, the reasons for not progressing to second line therapy at disease progression at our cancer centre and to use this data as a way to institute it into clinical practice in our cancer centre. METHOD: This study was approved by the ethics committee. The data was collected from a purpose built cancer unit database, patient and pharmacy records for all patients diagnosed with Stage 3 and 4 non-small cell lung cancer between 2005 - 2011. Demographic information was collected and subgroup analysis of mean overall survival was obtained. Reasons for not progressing to second line therapy were also analysed. RESULTS: Of the 105 patients available for analysis, 44 achieved stable disease/partial response (SD/PR) post first cycle of which 42 were eligible for maintenance chemotherapy, 7 went onto receive maintenance with a mean overall survival (OS) of 18.26 months, 23 received second line with the highest OS of 28.19 months and 12 didn’t receive either with the lowest OS of 11.52 months. The majority of these patients did not receive second line at disease progression because of being too unwell. CONCLUSION: Similar data on the progression to second line chemotherapy in this patient group was seen. Those that received second line chemotherapy had higher overall survival and thus maintenance therapy could be a means to allow patients to be fit enough to receive second line when they need it.