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

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.

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.

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.

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.