CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(02): 073-079
DOI: 10.4103/sajc.sajc_294_18
REVIEW ARTICLE

First-line management of metastatic non-small cell lung cancer: An Indian perspective

Nikhil Suresh Ghadyalpatil
Department of Medical Oncology, Yashoda Hospital, Hyderabad, Telangana
,
Avinash Pandey
Department of Medical Oncology, IGIMS, Patna, Bihar
,
Iyer Krishnamani
Department of Medical Oncology, Care Hospital, Hyderabad, Telangana
,
Chilukuri Srinivas
Department of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu
,
Shabnam J. Rafiq
Department of Medical Oncology, Yashoda Hospital, Hyderabad, Telangana
,
Sachin S. Hingmire
Department of Medical Oncology, Deenanath Mangeshkar Hospital, Pune, Maharashtra
,
Nagarjuna Maturu
Department of Pulmonology, Yashoda Hospital, Hyderabad, Telangana
,
Ragotham Reddy
Department of Pulmonology, Yashoda Hospital, Hyderabad, Telangana
,
Kiran K. Kumar
Department of Radiation Oncology, Yashoda Hospital, Hyderabad, Telangana
,
K. Sreekanth
Department of Surgical Oncology, Yashoda Hospital, Hyderabad, Telangana
,
Bharath Chandra Gurram
Department of Radiation Oncology, Yashoda Hospital, Hyderabad, Telangana
,
P. M. Parikh
Department of Medical Oncology, Asian Institute of Oncology, Mumbai, Maharashtra
› Author Affiliations
Financial support and sponsorship: Nil.

Abstract

Lung cancer has been the most common cancer in the world for several decades. The non-small cell lung cancer (NSCLC) constitutes approximately about 80% of the total cases of lung cancer. Therapeutic interventions in NSCLC have shifted to the target-based approach from histology-based approach, and this has completely changed the face of the management of NSCLC. Developing countries, such as India, have very limited data compiled about the prevalence and treatment practices of lung cancer, despite a large burden of the disease. However, in recent times, there has been a lot of data generated in this regard. This article is an attempt to collate and shine light on the available data for the first-line treatment of NSCLC in India keeping in mind the current standards of care in this area.



Publication History

Publication Date:
21 December 2020 (online)

© 2019. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Ferlay JS, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 10. Lyon, France: International Agency for Research on Cancer; 2008. Available from: http://www.globocan.iarc.fr. [Last accessed on 2013 Jul 02].
  • 2 Indian Council of Medical Research. National Cancer Registry Programme. Three Year Report of Population Based Cancer Registries: 2009-2011; 2013. Available from: http://www.ncrpindia.org. [Last accessed on 2014 Jan 21].
  • 3 Chandra S, Mohan A, Guleria R, Singh V, Yadav P. Delays during the diagnostic evaluation and treatment of lung cancer. Asian Pac J Cancer Prev 2009;10:453-6.
  • 4 Parikh PM, Ranade AA, Govind B, Ghadyalpatil N, Singh R, Bharath R, et al. Lung cancer in India: Current status and promising strategies. South Asian J Cancer 2016;5:93-5.
  • 5 Lynch TJ, Bondarenko I, Luft A, Serwatowski P, Barlesi F, Chacko R, et al. Ipilimumab in combination with paclitaxel and carboplatin as first-line treatment in stage IIIB/IV non-small-cell lung cancer: Results from a randomized, double-blind, multicenter phase II study. J Clin Oncol 2012;30:2046-54.
  • 6 Marino P, Pampallona S, Preatoni A, Cantoni A, Invernizzi F. Chemotherapy vs. supportive care in advanced non-small-cell lung cancer. Results of a meta-analysis of the literature. Chest 1994;106:861-5.
  • 7 Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346:92-8.
  • 8 Baggstrom MQ, Stinchcombe TE, Fried DB, Poole C, Hensing TA, Socinski MA, et al. Third-generation chemotherapy agents in the treatment of advanced non-small cell lung cancer: A meta-analysis. J Thorac Oncol 2007;2:845-53.
  • 9 Shajeem O, Behera D, Aggarwal AN. Chemotherapy versus best supportive care in the management of lung cancer. J Assoc Physicians India 2003;51:261-4.
  • 10 Behera D, Aggarwal AN, Sharma SC, Gupta D, Jindal SK. Ifosfamide containing regimen for non-small cell lung cancer. Indian J Chest Dis Allied Sci 2004;46:9-15.
  • 11 Natukula K, Jamil K, Pingali UR, Suresh Attili VS, Naidu Madireddy UR. Survival analysis in advanced non small cell lung cancer treated with platinum based chemotherapy in combination with paclitaxel, gemcitabine and etoposide. Asian Pac J Cancer Prev 2013;14:4661-6.
  • 12 Rajappa S, Gundeti S, Talluri MR, Digumarti R. Chemotherapy for advanced lung cancer: A 5-year experience. Indian J Cancer 2008;45:20-6.
  • 13 Pathak AK, Bhutani M, Guleria R, Bal S, Mohan A, Mohanti BK, et al. Chemotherapy alone vs. chemotherapy plus high dose multiple antioxidants in patients with advanced non small cell lung cancer. J Am Coll Nutr 2005;24:16-21.
  • 14 Bala S, Gundeti S, Linga VG, Maddali LS, Digumarti RR, Uppin SG, et al. Clinicopathological features and outcomes in advanced nonsmall cell lung cancer with tailored therapy. Indian J Med Paediatr Oncol 2016;37:242-50.
  • 15 Hingmire SS, Sambhus MB, Kelkar DS, Joshi SW, Narsinghpura KS. First-line therapy outcomes in patients with advanced stage nonsmall cell lung cancer treated at nongovernment tertiary care centrer in India: Experience from a real world practice. Indian J Cancer 2017;54:182-6.
  • 16 Doval DC, Sinha R, Batra U, Choudhury KD, Azam S, Mehta A, et al. Clinical profile of nonsmall cell lung carcinoma patients treated in a single unit at a tertiary cancer care center. Indian J Cancer 2017;54:193-6.
  • 17 Babu KG, Prabhash K, Vaid AK, Sirohi B, Diwakar RB, Rao R, et al. Nimotuzumab plus chemotherapy versus chemotherapy alone in advanced non-small-cell lung cancer: A multicenter, randomized, open-label phase II study. Onco Targets Ther 2014;7:1051-60.
  • 18 Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol 2008;26:3543-51.
  • 19 Louis RA, Rajendranath R, Ganesan P, Sagar TG, Krishnamurthy A. First report of upfront treatment with gefitinib in comparison with chemotherapy in advanced non-small cell lung cancer patients from South India: Analysis of 120 patients. Indian J Med Paediatr Oncol 2012;33:146-54.
  • 20 Paliwal P, Rajappa S, Santa A, Mohan M, Murthy S, Lavanya N, et al. Clinical profile and outcomes of patients with stage IV adenocarcinoma of lung: A tertiary cancer center experience. Indian J Cancer 2017;54:197-202.
  • 21 Yang JC, Kang JH, Mok T, Ahn MJ, Srimuninnimit V, Lin CC, et al. First-line pemetrexed plus cisplatin followed by gefitinib maintenance therapy versus gefitinib monotherapy in East Asian patients with locally advanced or metastatic non-squamous non-small cell lung cancer: A randomised, phase 3 trial. Eur J Cancer 2014;50:2219-30.
  • 22 Yang JC, Srimuninnimit V, Ahn MJ, Lin CC, Kim SW, Tsai CM, et al. First-line pemetrexed plus cisplatin followed by gefitinib maintenance therapy versus gefitinib monotherapy in East Asian never-smoker patients with locally advanced or metastatic nonsquamous non-small cell lung cancer: Final overall survival results from a randomized phase 3 study. J Thorac Oncol 2016;11:370-9.
  • 23 Patil VM, Noronha V, Joshi A, Choughule AB, Bhattacharjee A, Kumar R, et al. Phase III study of gefitinib or pemetrexed with carboplatin in EGFR-mutated advanced lung adenocarcinoma. ESMO Open 2017;2:e000168.
  • 24 Paz-Ares L, de Marinis F, Dediu M, Thomas M, Pujol JL, Bidoli P, et al. Maintenance therapy with pemetrexed plus best supportive care versus placebo plus best supportive care after induction therapy with pemetrexed plus cisplatin for advanced non-squamous non-small-cell lung cancer (PARAMOUNT): A double-blind, phase 3, randomised controlled trial. Lancet Oncol 2012;13:247-55.
  • 25 Paz-Ares LG, de Marinis F, Dediu M, Thomas M, Pujol JL, Bidoli P, et al. PARAMOUNT: Final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol 2013;31:2895-902.
  • 26 Reck M, Paz-Ares LG, de Marinis F, Molinier O, Sahoo TP, Laack E, et al. PARAMOUNT: Descriptive subgroup analyses of final overall survival for the phase III study of maintenance pemetrexed versus placebo following induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Thorac Oncol 2014;9:205-13.
  • 27 Gridelli C, de Marinis F, Thomas M, Prabhash K, El Kouri C, Blackhall F, et al. Final efficacy and safety results of pemetrexed continuation maintenance therapy in the elderly from the PARAMOUNT phase III study. J Thorac Oncol 2014;9:991-7.
  • 28 Pandey AV, Phillip DS, Noronha V, Joshi A, Janu A, Jambekar N, et al. Maintenance pemetrexed in nonsmall cell lung carcinoma: Outcome analysis from a tertiary care center. Indian J Med Paediatr Oncol 2015;36:238-42.
  • 29 Pandey A, Noronha V, Joshi A, Prabhash K. Switch maintenance tyrosine kinase inhibitors in EGFR mutation positive metastatic non-squamous NSCLC: Experience from the real world. Gulf J Oncolog 2016;1:6-10.
  • 30 Pankaj G, Ullas B, Doval DC, Parveen J, Amitabh UK, Dash PK, et al. Efficacy and toxicity profile of maintenance pemetrexed in patients with stage IV adenocarcinoma lung in Indian population. South Asian J Cancer 2016;5:196-203.
  • 31 Murali AN, Radhakrishnan V, Ganesan TS, Rajendranath R, Ganesan P, Selvaluxmy G, et al. Outcomes in lung cancer: 9-year experience from a tertiary cancer center in India. J Glob Oncol 2017;3:459-68.
  • 32 Mohan A, Poulose R, Gupta T, Luthra K, Pandey RM, Madan K, et al. Impact of chemotherapy on symptom profile, oxidant-antioxidant balance and nutritional status in non-small cell lung cancer. Lung India 2017;34:336-40.
  • 33 Veldore VH, Rao RM, Kakara S, Pattanayak S, Tejaswi R, Sahoo R, et al. Epidermal growth factor receptor mutation in non-small-cell lung carcinomas: A retrospective analysis of 1036 lung cancer specimens from a network of tertiary cancer care centers in India. Indian J Cancer 2013;50:87-93.
  • 34 Sebastian M, Schmittel A, Reck M. First-line treatment of EGFR-mutated nonsmall cell lung cancer: Critical review on study methodology. Eur Respir Rev 2014;23:92-105.
  • 35 Solomon BJ, Mok T, Kim DW, Wu YL, Nakagawa K, Mekhail T, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med 2014;371:2167-77.
  • 36 Mehta J. Molecular epidemiology of epidermal growth factor receptor mutations in lung cancers in Indian population. Indian J Cancer 2013;50:102-6.
  • 37 Parikh P, Chang AY, Nag S, Digumarti R, Bhattacharyya GS, Doval DC, et al. Clinical experience with gefitinib in Indian patients. J Thorac Oncol 2008;3:380-5.
  • 38 Louis RA, Rajendranath R, Ganesan P, Sagar TG, Krishnamurthy A. First report of upfront treatment with gefitinib in comparison with chemotherapy in advanced non-small cell lung cancer patients from South India: Analysis of 120 patients. Indian J Med Paediatr Oncol 2012;33:146-54.
  • 39 Bhatt AD, Pai R, Rebekah G, Nehru GA, Dhananjayan S, Samuel A, et al. Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status. Indian J Cancer 2013;50:94-101.
  • 40 Noronha V, Prabhash K, Thavamani A, Chougule A, Purandare N, Joshi A, et al. EGFR mutations in Indian lung cancer patients: Clinical correlation and outcome to EGFR targeted therapy. PLoS One 2013;8:e61561.
  • 41 Noronha V, Patil VM, Joshi A, Tandon N, Sharma V, Ramaswamy A, et al. Epidermal growth factor receptor positive lung cancer: The nontrial scenario. Indian J Cancer 2017;54:132-5.
  • 42 Malik PS, Jain D, Kumar L. Epidermal growth factor receptor tyrosine kinase inhibitors in advanced non-small cell lung cancer. Oncology 2016;91 Suppl 1:26-34.
  • 43 Joshi A, Patil V, Noronha V, Chougule A, Bhattacharjee A, Kumar R, et al. Efficacy of gefitinib in epidermal growth factor receptor-activating mutation-positive nonsmall cell lung cancer: Does exon 19 deletion differ from exon 21 mutation? Lung India 2018;35:27-30.
  • 44 Noronha V, Patil V, Joshi A, Chougule A, Bhattacharjee A, Kumar R, et al. Impact of exon 19 versus exon 21 EGFR-activating mutation on outcomes with upfront pemetrexed-carboplatin chemotherapy. Ecancermedicalscience 2017;11:776.
  • 45 Yasuda H, Kobayashi S, Costa DB. EGFR exon 20 insertion mutations in non-small-cell lung cancer: Preclinical data and clinical implications. Lancet Oncol 2012;13:e23-31.
  • 46 Noronha V, Choughule A, Patil VM, Joshi A, Kumar R, Susan Joy Philip D, et al. Epidermal growth factor receptor exon 20 mutation in lung cancer: Types, incidence, clinical features and impact on treatment. Onco Targets Ther 2017;10:2903-8.
  • 47 Under the aegis of Lung Cancer Consortium Asia (LCCA), Indian Cooperative Oncology Network (ICON), Indian Society of Medical & Pediatric Oncology (ISMPO), Molecular Oncology Society (MOS) and Association of Physicians of India API). Indian consensus statement for treatment of advanced non small cell lung cancer:First line, maintenance, and second line. Indian J Cancer 2017;54:89-103.
  • 48 Noronha V, Chandrakanth MV, Joshi AP, Patil V, Chougule A, Mahajan A, et al. ROS1 rearranged nonsmall cell lung cancer and crizotinib: An Indian experience. Indian J Cancer 2017;54:436-8.
  • 49 Weickhardt AJ, Aisner DL, Franklin WA, Varella-Garcia M, Doebele RC, Camidge DR, et al. Diagnostic assays for identification of anaplastic lymphoma kinase-positive non-small cell lung cancer. Cancer 2013;119:1467-77.
  • 50 Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, et al. Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer. N Engl J Med 2017;377:829-38.
  • 51 Soria JC, Tan DSW, Chiari R, Wu YL, Paz-Ares L, Wolf J, et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): A randomised, open-label, phase 3 study. Lancet 2017;389:917-29.
  • 52 Dubey AP, Pathi N, Viswanath S, Rathore A, Pathak A, Sud R, et al. New insights into anaplastic lymphoma kinase-positive nonsmall cell lung cancer. Indian J Cancer 2017;54:203-8.
  • 53 Noronha V, Ramaswamy A, Patil VM, Joshi A, Chougule A, Kane S, et al. ALK positive lung cancer: Clinical profile, practice and outcomes in a developing country. PLoS One 2016;11:e0160752.
  • 54 Joshi AP, Chandrakanth MV, Noronha V, Patil V, Chougule A, Mahajan A, et al. Ceritinib in anaplastic lymphoma kinase-positive nonsmall cell lung cancer among patients who were previously exposed to crizotinib: Experience from the Indian subcontinent. Indian J Cancer 2017;54:144-7.
  • 55 Murthy SS, Rajappa SJ, Gundimeda SD, Mallavarapu KM, Ayyagari S, Yalavarthi P, et al. Anaplastic lymphoma kinase status in lung cancers: An immunohistochemistry and fluorescence in situ hybridization study from a tertiary cancer center in India. Indian J Cancer 2017;54:231-5.
  • 56 Batra U, Aggarwal M, Jain P, Goyal P, Yadav A, Maheshwari U, et al. Clinical outcome study of crizotinib in immunohistochemistry-proven echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene among Indian patients with adenocarcinoma lung. South Asian J Cancer 2018;7:61-4.
  • 57 Bamania A, Sahni D, Mohan A, Malik P, Madan K, Hadda V. Clinical Response to Crizotinib as a 1st and 2nd Line Therapy in ALK Positive Lung Cancer in an Indian Population. American Journal of Respiratory and Critical Care Medicine. 2017;195(A4589).
  • 58 Bal A, Singh N, Agarwal P, Das A, Behera D. ALK gene rearranged lung adenocarcinomas: Molecular genetics and morphology in cohort of patients from North India. APMIS 2016;124:832-8.
  • 59 Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, et al. Cancer mortality in India: A nationally representative survey. Lancet 2012;379:1807-16.