Corrigendum: Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (Annals of Oncology (2018) 29 (iv192–iv237) DOI: 10.1093/annonc/mdy275)

Abstract

The following corrections are made: In the section "Management of advanced/metastatic NSCLC, First-line treatment of EGFR-and ALK-negative NSCLC disease, regardless of PD-L1 status" 1. In KEYNOTE-189, patients with metastatic non-squamous NSCLC, PS 0-1, without sensitising EGFR or ALK mutations, were randomised to receive pemetrexed and a platinum-based ChT plus either 200 mg of pembrolizumab or placebo every 3 weeks for 4 cycles, followed by pembrolizumab or placebo for up to a total of 35 cycles plus pemetrexed maintenance therapy [96]. Is replaced with: In KEYNOTE-189, patients with metastatic non-squamous NSCLC, PS 0-1, without sensitising EGFR or ALK mutations, were randomised to receive pemetrexed and cisplatin or carboplatin plus either 200 mg of pembrolizumab or placebo every 3 weeks for 4 cycles, followed by pembrolizumab or placebo for up to a total of 35 cycles plus pemetrexed maintenance therapy [96]. 2. Recently, the combination of carboplatin or cisplatin with pemetrexed and atezolizumab has been shown, in the context of the IMpower132 trial, to be superior to the ChT doublet. Is replaced with: Recently, the combination of carboplatin or cisplatin with pemetrexed and atezolizumab followed by maintenance pemetrexed and atezolizumab has been shown, in the context of the IMpower132 trial, to be superior to the ChT doublet followed by maintenance pemetrexed. 3. Atezolizumab was studied in patients with metastatic squamous NSCLC in the IMpower131 study. Patients were randomised to atezolizumab/ carboplatin/paclitaxel, atezolizumab/carboplatin/nab-P or carboplatin/nab-P (nab-PC) [100]. Atezolizumab/carboplatin/ nab-P had improved PFS compared with nab-PC (HR 0.715, P=0.0001), but no improvement in OS was seen at the first interim analysis (mOS 14 versus 13.9 months). More mature data are needed to evaluate long-Term benefit of the strategy; with the use of atezolizumab with nab-PC today representing an option in patients with metastatic squamous NSCLC [I, B; not EMA-Approved]. Is replaced with: Atezolizumab was studied in patients with metastatic squamous NSCLC in the IMpower131 study. Patients were randomised to atezolizumab/ carboplatin/paclitaxel, atezolizumab/carboplatin/nab-P or carboplatin/nab-P [100]. Atezolizumab/carboplatin/nab-P had improved PFS compared with carboplatin/nab-P (HR 0.715, P=0.0001), but no improvement in OS was seen at the first interim analysis (mOS 14 versus 13.9 months). More mature data are needed to evaluate the long-Term benefit of the strategy; with the use of atezolizumab with carboplatin and nab-P today representing an option in patients with metastatic squamous NSCLC [I, B; not EMAapproved]. In the section "First-line treatment of NSCLC without actionable oncogenic driver, with contraindications to use of immunotherapy" The nab-PC regimen has been shown in a large phase III trial to have a significantly higher ORR compared with solvent-based paclitaxel/ carboplatin (sb-PC), and less neurotoxicity [I, B] [113]. The benefits were observed in both SCC and non-SCC (NSCC), with a larger impact on response in SCC. For this reason, the nab-PC regimen could be considered a chemotherapeutic option in advanced NSCLC patients, particularly in patients with greater risk of neurotoxicity, pre-existing hypersensitivity to paclitaxel or contraindications for standard paclitaxel premedication [I, B]. Is replaced with: The carboplatin/nab-P regimen has been shown in a large phase III trial to have a significantly higher ORR compared with solventbased paclitaxel/carboplatin (sb-PC), and less neurotoxicity [I, B] [113]. The benefits were observed in both SCC and non-SCC (NSCC), with a larger impact on response in SCC. For this reason, the carboplatin/nab-P regimen could be considered a chemotherapeutic option in advanced NSCLC patients, particularly in patients with greater risk of neurotoxicity, pre-existing hypersensitivity to paclitaxel or contraindications for standard paclitaxel premedication [I, B]. (Figure Presented).