Efficacy of second- and third-line chemotherapy after chemotherapy with platinum doublet and immunotherapy in non-small cell lung cancer: a descriptive study.

Background: The efficacy of second-line chemotherapy with pemetrexed or docetaxel was evaluated in phase III clinical trials only after prior treatment with a platinum doublet in non-small cell lung cancer. The effectiveness of second-line chemotherapy after previous chemotherapy and immunotherapy is not well known. The effectiveness of third-line chemotherapy is not practically proven in this sense. The aim of this retrospective study was therefore to assess the effectiveness of second- and third-line chemotherapy in patients pretreated with chemotherapy with platinum doublet and immunotherapy based on retrospective data.

Methods: Patients from the Czech Lung Cancer Focus (LUCAS) lung cancer registry who were pretreated with chemotherapy and immunotherapy were evaluated. Time on treatment (ToT) and overall survival (OS) with second- and third-line chemotherapy were evaluated using Kaplan-Meier method.

Results: One hundred and fourteen patients treated with second-line chemotherapy were evaluated. Their ToT reached a median of 2.9 [95% confidence interval (CI): 2.4-4.7] months and OS a median of 7.2 (95% CI: 6.1-11.2) months. Twenty-two patients treated with third-line chemotherapy were evaluated. Their ToT reached a median of 5.1 (95% CI: 1.4-NA) months and OS a median of 13.8 (95% CI: 6.1-NA) months.

Conclusions: The efficacy of second-line chemotherapy in our group of patients (pretreated with chemotherapy and immunotherapy) was comparable with registration studies for second-line chemotherapy. In a selected population, even third-line chemotherapy can be effective.