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Careful initial diagnostic evaluation to define the location and to determine the extent of primary and metastatic tumor involvement is critical for the appropriate care of patients. This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of non-small cell lung cancer. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions. Incidences of grade 3 to 4 events, regardless of attribution, included hypertension (14%), increased alanine aminotransferase (13%), increased aspartate aminotransferase (10%), hyponatremia (6%), and lymphopenia (6%). In the entire study cohort of 531 patients, dose reductions occurred in 30% of patients, while 2% discontinued selpercatinib because of treatment-related adverse events .

Febrile neutropenia, fatigue, and hypertension were among the toxicities that were more common with the addition of ramucirumab to docetaxel. There was no significant difference in the incidence of grades 3 to 4 hemorrhage between the groups. The objective response rate was 2% in patients who received everolimus and 1% in patients who received placebo. Disease stabilization was observed in 81% of patients in the everolimus arm and 64% of patients in the placebo arm. Two trials have evaluated the addition of cetuximab to first-line combination chemotherapy. The addition of surgery to chemoradiation therapy for patients with stage IIIA NSCLC did not result in improved OS in a phase III trial but did improve progression-free survival and local control.

Close or microscopically positive resection margins. Preoperative chemotherapy may, however, delay potentially curative surgery. There was no difference in overall survival , disease-free survival , local recurrence, and regional recurrence. There was no difference in OS, disease-free survival , local recurrence, and regional recurrence. The rate of locoregional recurrence was significantly less after lobectomy, regardless of primary tumor size. A high incidence of second primary cancers develop in these patients.

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A randomized phase III trial of 571 patients was designed to demonstrate the noninferiority of pemetrexed compared with docetaxel.The trial showed no difference in response rates, PFS, or OS between treatments. On the basis of this study, the addition of ramucirumab to docetaxel chemotherapy can be considered for patients with good performance status with advanced NSCLC who have progressive disease after first-line chemotherapy. Grade 3 to 4 events, regardless of attribution, included hypertension (14% of participants), increased alanine aminotransferase (in 13%), increased aspartate aminotransferase (in 10%), hyponatremia (in 6%), and lymphopenia (in 6%).

Three-drug combinations of the commonly used chemotherapy drugs do not result in superior survival and are more toxic than two-drug combinations. Cisplatin and carboplatin yield similar improvements in outcome with different toxic effects. Some, but not all, trials and meta-analyses of trials suggest that outcomes with cisplatin may be superior, although with a higher risk of certain whatdoesitmean sorcha faal toxicities such as nausea and vomiting. Maintenance chemotherapy after four cycles of platinum combination chemotherapy may improve PFS and OS. This study, which was performed in eight centers in Brazil and one center in the United States, reported rates of OS and PFS that were higher than has historically been noted in most, although not all, other published studies.