Research Papers:

Value of chemotherapy post immunotherapy in stage IV non-small cell lung cancer (NSCLC)

Hazem I. Assi, Maroun Bou Zerdan, Mohammad Hodroj, Makram Khoury, Nour Sabiha Naji, Ghid Amhaz, Reine Abou Zeidane and Fadi El Karak _

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Oncotarget. 2023; 14:517-525. https://doi.org/10.18632/oncotarget.28444

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Hazem I. Assi1,*, Maroun Bou Zerdan1,*, Mohammad Hodroj1, Makram Khoury2, Nour Sabiha Naji1, Ghid Amhaz1, Reine Abou Zeidane1 and Fadi El Karak2

1 Department of Internal Medicine, Division of Hematology and Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon

2 Department of Internal Medicine, Division of Hematology and Oncology, Hotel Dieu de France University Hospital, Beirut, Lebanon

* These authors contributed equally to this work

Correspondence to:

Fadi El Karak, email: [email protected]

Keywords: chemotherapy; immunotherapy; non-small cell lung cancer

Received: February 06, 2023     Accepted: May 05, 2023     Published: May 26, 2023

Copyright: © 2023 Assi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Lung cancer is the number one cause of mortality among all types of cancer worldwide. Its treatment landscape has shifted from the classic chemotherapy alone to newer regimens based on the discovery of new immunotherapy and targeted therapy drugs. However, chemotherapy is still an option for treatment of advanced non-small cell lung cancer (NSCLC) after progression on immunotherapy alone or in combination with first-line chemotherapy.

Methods: This is a retrospective study based on chart review of patients diagnosed with advanced NSCLC cases who received Docetaxel as second or third line after being treated by immunotherapy and/or chemotherapy in previous lines. The data was collected from the medical records of physicians’ clinics in three different hospital centers in Lebanon over the period of 5 years from July 2015 until December 2020. February 2021 was data analysis cut off time. The main aim was to assess the role of Docetaxel post-chemoimmunotherapy for patients with diagnosed NSCLC.

Results: A total of 21 patients were included in this study. The majority of our patients were males (81%). As for histologic type, most patients had non-squamous lung cancer (67%) as compared to 33% who had squamous lung cancer. Overall, our study reported a 24% response rate to Docetaxel including stable disease and partial response and a median progression free survival (PFS) of 3 months. The mean time interval elapsed from diagnosis to the initiation of Docetaxel was 11.5 months.

Conclusion: New therapeutic options should be validated for the treatment of NSCLC in the second and subsequent lines of therapy considering the poor prognosis of this disease. The chemotherapy in second and third line may keep an important role in the treatment after progression on newer agents, but it needs more evidence in prospective studies including a larger number of patients.

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