[Difference in Chemotherapy for Lung Cancer between Asian and Caucasian]

Currently, targeted therapies or immune checkpoint inhibitors(plus cytotoxic chemotherapy), have been used for patients with stage Ⅳ non-small cell lung cancer as first-line treatment, based on driver gene alterations. In Asia, EGFR mutation- positive non-small cell lung cancer patients are more frequently observed, and many clinical trials using EGFR tyrosine- kinase inhibitors have been conducted. It has been shown that there is higher frequency of myelosuppression, such as neutropenia, in patients receiving cytotoxic chemotherapy, and interstitial lung disease caused by targeted therapies or immune checkpoint inhibitors has been more frequently reported, compared with Caucasian. In Japan, docetaxel monotherapy had been a standard treatment for elderly patients, aged 70 or 75 years or older. Recently, the results of 2 phase Ⅲ trials have been reported, and platinum-based chemotherapy became a standard treatment even for elderly patients. In Japan, cancer gene panel testing is now available with the insurance reimbursement system, and many lung cancer patients will have known genetic profiles. In addition, it is expected that more drugs will become accessible, based on genetic profile data.