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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/3\\\/10\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/3\\\/10\u0022}],\u0022ac\u0022:{\u0022spmdc;14\\\/3\\\/10\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;14\\\/3\\\/10\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EResearchers in Egypt conducting a prospective, Phase 3, randomized trial found no significant difference in time to progression or overall survival in patients with stage IV advanced and metastatic non\u2014small cell lung cancer (NSCLC) who received either gemcitabine or best supportive care after induction therapy. Findings were displayed in a poster presentation.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECancer Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERespiratory Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPulmonary \u0026amp; Respiratory Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EResearchers in Egypt conducting a prospective, Phase 3, randomized trial found no significant difference in time to progression (TTP) or overall survival (OS) in patients with stage IV advanced and metastatic non-small cell lung cancer (NSCLC) who received either gemcitabine or best supportive care (BSC) after induction therapy. Findings were displayed in a poster presentation.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EMaintenance therapy in NSCLC has been extensively investigated. Evidence suggests that first-line cytotoxic combination chemotherapy should be stopped at disease progression or after 4 cycles in patients whose disease is nonresponsive to treatment [Brodowicz T et al. \u003Cem\u003ELung Cancer\u003C\/em\u003E 2006; Park 10 et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2007; Socinski MA et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2002; von Plessen C et al. \u003Cem\u003EBr J Cancer\u003C\/em\u003E 2006].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPretrexed continuation maintenance therapy is well tolerated and offers superior OS compared with placebo [PARAMOUNT (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00102804\u0026amp;atom=%2Fspmdc%2F14%2F3%2F10.atom\u0022\u003ENCT00102804\u003C\/a\u003E); Paz-Ares L et al. \u003Cem\u003ELancet Oncol\u003C\/em\u003E 2012], and maintenance therapy with erlotinib produced significantly longer progression-free survival [A Study of Tarceva (Erlotinib) Following Platinum-Based Chemotherapy in Patients With Advanced, Recurrent, or Metastatic Non-Small Cell Lung Cancer (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00556712\u0026amp;atom=%2Fspmdc%2F14%2F3%2F10.atom\u0022\u003ENCT00556712\u003C\/a\u003E); Cappuzzo F et al. \u003Cem\u003ELancet Oncol\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe purpose of this study, which was conducted by the Clinical Oncology and Nuclear Medicine Department at Ain Shams University Hospitals in Cairo, Egypt, was to evaluate the efficacy\u2014defined as prolongation of TTP, OS, and safety (grade 3 or 4 toxicity)\u2014of low-dose gemcitabine as maintenance chemotherapy after first-line gemcitabine and cisplatin in advanced and metastatic NSCLC.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EA total of 120 patients with advanced NSCLC presented at the Clinical Oncology and Nuclear Medicine Department at Ain Shams University Hospitals between January 2010 and June 2012. Of these, 75.5% were male, 70% were younger than 60 years, 59.2% had performance status (PS) 2, 2.75% had nonsquamous histology, and 79.2% had stage IV disease. All eligible patients received induction chemotherapy with gemcitabine and cisplatin.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPatients who completed 4 cycles and showed complete response, partial response, or stable disease were randomized into two arms: (1) gemcitabine 250 mg\/m\u003Csup\u003E2\u003C\/sup\u003E given throughout 6 hours on days 1 and 8 every 3 weeks, or (2) BSC. Responses were assessed according to Response Evaluation Criteria in Solid Tumors guidelines every 2 cycles.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EAfter each cycle, toxicities were evaluated according to National Cancer Institute criteria for common toxicities. Patients with progressive disease (PD) were excluded from the study, as were those who did not finish 4 cycles and showed doubling time, PD, or toxicity.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EResults showed a median TTP of 6.1 months (CI, 5.3 to 6.6; p=0.454) in arm I and 5.8 months (CI, 5.2 to 6.4; p=0.454) in arm II. The median OS was 9 months (CI, 7.9 to 10.0; p=0.994) in arm I and 8 months (CI, 8.5 to 9.4; p=0.994) in arm II. The trial showed that maintenance therapy was well tolerated, with no grade 3 or 4 toxicity. The only significant finding was grade 2 anemia in 8 patients (22.9%) in the maintenance arm (arm I).\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EThe clinical trial failed to show any statistical significance in TTP or OS between the 2 arms. The authors report that this could be due to the smaller sample size or the use of low-dose rather than conventional-dose gemcitabine. Other factors might include the predominance of nonsquamous histology and PS 2.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EEvidence-based data indicate that this analysis of study outcomes is accurate. PS is among the most important prognostic factors for survival with NSCLC [Sweeney CJ et al. \u003Cem\u003ECancer\u003C\/em\u003E 2001]. PS, histology, and age versus comorbidity are the principal determinants of first-line treatment with cytotoxic combination chemotherapy, including platinum with gemcitabine. Treatment goals are to prolong survival and control disease-related symptoms. First-line treatment with platinum combinations, such as gemcitabine, yields similar improvements in survival [National Cancer Institute online 2014].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/3\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzpasp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}