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Squamous Non-Small Cell Lung Cancer sqNSCLCPhase 4PULSENCT07744698

Metronomic Oral Paclitaxel Plus PD-1/ PD-L1 Inhibitor Maintenance in Advanced Lung Cancer (PULSE Study)

A Phase 4 study testing Paclitaxel Oral Solution and PD-1/PD-L1 inhibitor (eg. Tislelizumab) in people with Squamous Non-Small Cell Lung Cancer sqNSCLC and Extensive-stage Small Cell Lung Cancer (ES-SCLC), run by Anhui Provincial Cancer Hospital at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record

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Trial summary

This study will evaluate the efficacy and safety of metronomic oral paclitaxel combined with a PD-1 or PD-L1 inhibitor as maintenance therapy in patients with advanced lung cancer whose disease has not progressed after first-line chemoimmunotherapy. The study will include two independently analyzed cohorts. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
Paclitaxel Oral Solution and PD-1/PD-L1 inhibitor (eg. Tislelizumab)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
107 participants
Where
1 siteChina
Study dates
24 Jul 2026to Jun 2029
Phase
Phase 4

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. The participant has been fully informed about the study, voluntarily agrees to participate, provides written informed consent, and is willing to comply with long-term follow-up and study medication management.
  • 2. Age 18 to 75 years, inclusive.
  • 3. The participant meets the disease-specific requirements for either Cohort A or Cohort B: - Cohort A: Histologically and/or cytologically confirmed squamous non-small cell lung cancer(sqNSCLC), clinical stage IIIB to IV, unresectable and not suitable for definitive chemoradiotherapy, without actionable driver-gene alterations, and treatment-naive before initiation of first-line induction therapy. - Cohort B: Histologically and/or cytologically confirmed extensive-stage small cell lung cancer (ES-SCLC), defined according to the eighth edition of the American Joint Committee on Cancer staging system as stage IV disease, including any T, any N, and M1a, M1b, or M1c disease, or T3 to T4 disease due to multiple pulmonary nodules or disease that is too extensive or bulky to be included within a tolerable definitive radiotherapy field.
  • 4. The participant has completed the required first-line induction regimen: - Cohort A: Completion of four cycles of a PD-1 or PD-L1 inhibitor plus cisplatin or carboplatin and paclitaxel or nab-paclitaxel, with a best induction response of complete response (CR), partial response (PR), or stable disease (SD) and no evidence of disease progression. - Cohort B: Completion of four cycles of a PD-1 or PD-L1 inhibitor plus cisplatin or carboplatin and etoposide, with a best induction response of CR, PR, or SD and no evidence of disease progression.
  • 5. The last dose of first-line induction treatment was administered no more than 28 days before the first study treatment.
  • 6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
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  • 7. Estimated life expectancy of at least 3 months.
  • 8. Adequate bone marrow and organ function, including: - Absolute neutrophil count (ANC) of at least 1.5 × 10⁹/L, platelet count of at least 100 × 10⁹/L, and hemoglobin of at least 90 g/L, without blood transfusion, growth-factor support, or erythropoietin within 14 days before assessment. - International normalized ratio (INR) and/or prothrombin time (PT) no greater than 1.5 times the upper limit of normal (ULN), and activated partial thromboplastin time (APTT) no greater than 1.5 times ULN. Participants receiving anticoagulation are eligible if coagulation parameters are within the expected therapeutic range.- Total serum bilirubin no greater than 1.5 times ULN; for participants with Gilbert syndrome, total bilirubin no greater than 3 times ULN. - Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) no greater than 2.5 times ULN, or no greater than 5 times ULN in participants with documented liver metastases.- Serum creatinine no greater than 1.5 times ULN and creatinine clearance of at least 60 mL/min for participants who received cisplatin or greater than 45 mL/min for participants who received carboplatin, calculated using the Cockcroft-Gault formula. - Serum amylase and/or lipase no greater than 1.5 times ULN.
  • 9. At least one measurable lesion according to RECIST v1.1 before initiation of first-line induction therapy. Participants who achieve a CR and have no measurable lesion at maintenance-study entry remain eligible for progression-free survival (PFS) follow-up.
  • 10. Participants with central nervous system (CNS) metastases may be enrolled if previous CNS metastases have received local treatment with surgery and/or radiotherapy at least 2 weeks before enrollment, neurological symptoms are absent or stable, and treatment-related adverse events have recovered to grade 1 or lower. Participants should not require ongoing antiepileptic treatment. If corticosteroids are clinically required, the dose must be stable and no greater than 10 mg/day prednisone or equivalent.
  • 11. Participants of reproductive potential must agree to use an effective method of contraception during the study and for at least 3 months after the last study treatment. Women of childbearing potential must have a negative serum or urine pregnancy test before enrollment.

Who cannot join

  • 1. Known hypersensitivity to oral paclitaxel, an immune checkpoint inhibitor, or any component of the study drugs.
  • 2. Requirement for long-term treatment with a strong P-glycoprotein inhibitor that cannot be discontinued during the study.
  • 3. A gastrointestinal disorder within 6 months before the first study treatment that may substantially interfere with oral drug absorption, including complete intestinal obstruction. Previous gastrectomy alone is not an exclusion criterion.
  • 4. Active autoimmune disease or a history of autoimmune disease, including but not limited to interstitial pneumonitis, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, or nephritis. Participants with vitiligo, well-controlled type 1 diabetes mellitus, or hypothyroidism requiring only hormone-replacement therapy may be enrolled.
  • 5. Any of the following during previous immune checkpoint inhibitor (ICI) treatment: - Immune-related pneumonitis, immune-related myocarditis, or immune-related neurological toxicity of any grade. - Other grade 3 or higher immune-related adverse events (irAE) that have not recovered to grade 1 or lower or to baseline. - Grade 3 or higher irAE during first-line induction that have not recovered to grade 1 or lower or to baseline. - Permanent discontinuation of the ICI because of immune-related toxicity.
  • 6. Major surgery within 28 days before the first study treatment without adequate recovery, or planned major surgery during the study.
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  • 7. Active hepatitis, active tuberculosis, or another serious infection requiring systemic treatment, including active hepatitis C virus (HCV) infection, except for participants who are HCV antibody-positive but RNA-negative; active hepatitis B virus (HBV) infection with positive HBV surface antigen and HBV DNA greater than 2,000 IU/mL; bacteremia; or severe infectious pneumonia.
  • 8. Uncontrolled or serious cardiovascular disease, including: - Myocardial infarction, unstable angina, congestive heart failure of New York Heart Association class 2 or higher, or another serious cardiac disorder within 6 months before the first study treatment. - A clinically significant electrocardiographic (ECG) abnormality, including clinically significant arrhythmia or corrected QT interval greater than 450 milliseconds.- Left ventricular ejection fraction below 50% on echocardiography.
  • 9. Inability or unwillingness to comply with protocol requirements, or any condition that, in the investigator's judgment, makes the participant unsuitable for study participation.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Tian Tian, MD, PhD contact

+86-0551-65327751

drtiantian@ustc.edu.cn

Yueyin Pan, MD, PhD contact

+86-0551-65327751

panyueyin@ustc.edu.cn

China1 site, 1 recruiting
  • Anhui Cancer Hospital

    Hefei, Anhui, 230031

    Yueyin Pan, MD; PhD, 0551-65327751, panyueyin@ustc.edu.cn

    Recruiting

Other trials in China

About this study

Official title: Efficacy and Safety of Metronomic Oral Paclitaxel Plus an Immune Checkpoint Inhibitor as Maintenance Therapy After First-Line Induction in Advanced Squamous Non-Small Cell Lung Cancer and Extensive-Stage Small Cell Lung Cancer: A Multicenter, Multi-Cohort Exploratory Study

This study will evaluate the efficacy and safety of metronomic oral paclitaxel combined with a PD-1 or PD-L1 inhibitor as maintenance therapy in patients with advanced lung cancer whose disease has not progressed after first-line chemoimmunotherapy.

The study will include two independently analyzed cohorts. Cohort A will include patients with advanced squamous non-small cell lung cancer(sqNSCLC), and Cohort B will include patients with extensive-stage small cell lung cancer(ES-SCLC). All participants will receive oral paclitaxel three times weekly together with the same immune checkpoint inhibitor used during first-line induction therapy, whenever feasible.

The primary outcome is progression-free survival. Other outcomes include tumor response, overall survival, adverse events, treatment tolerability, and quality of life. Approximately 107 participants will be enrolled across multiple study centers.

Read the detailed description

Immune checkpoint inhibitor-based chemoimmunotherapy is a standard first-line treatment for advanced squamous non-small cell lung cancer and extensive-stage small cell lung cancer. However, many patients experience disease progression shortly after completing the chemotherapy component and entering the maintenance phase. More effective and tolerable maintenance strategies are therefore needed.

Metronomic chemotherapy uses relatively low doses of cytotoxic treatment administered repeatedly over time. In addition to direct antitumor activity, metronomic paclitaxel may modulate the tumor immune microenvironment and enhance the effects of immune checkpoint inhibition. An oral paclitaxel formulation may also be more suitable for long-term maintenance treatment than intravenous paclitaxel because it avoids repeated intravenous infusions.

This is a prospective, open-label, multicenter, nonrandomized, multi-cohort exploratory study. Participants must have completed four cycles of standard first-line chemoimmunotherapy and achieved complete response, partial response, or stable disease without disease progression.

Cohort A will enroll approximately 67 participants with advanced squamous non-small cell lung cancer(sqNSCLC). Cohort B will enroll approximately 40 participants with extensive-stage small cell lung cancer(ES-SCLC). Both cohorts will receive oral paclitaxel solution at 100 mg/m² per dose, administered orally three times weekly, together with a PD-1 or PD-L1 inhibitor administered every 3 weeks according to the approved or guideline-recommended regimen. The maintenance immune checkpoint inhibitor should generally remain the same as that used during induction therapy.

Treatment will continue until radiographic disease progression, unacceptable toxicity, withdrawal of consent, or another protocol-defined discontinuation criterion. Tumor assessments will generally be performed every 6 weeks, and safety assessments will generally be performed every 3 weeks.

The primary endpoint is progression-free survival measured from the first dose of oral paclitaxel. The two cohorts will be analyzed independently, and no formal efficacy comparison between the two cohorts is planned. Exploratory analyses will evaluate circulating tumor DNA, peripheral immune-cell subsets, inflammatory and immune-related factors, and PD-1/PD-L1-related biomarkers.

Being tested
Paclitaxel Oral Solution, PD-1/PD-L1 inhibitor (eg. Tislelizumab)
Keywords
Oral paclitaxel, Metronomic chemotherapy, Maintenance therapy, Immune checkpoint inhibitor, PD-1 inhibitor, PD-L1 inhibitor, sqNSCLC, ES-SCLC, Chemoimmunotherapy, First-line maintenance therapy
Medical subject headings
Small Cell Lung Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Paclitaxel Oral SolutionDrug

    Also called Oral paclitaxel, Liporaxel, DHP107

    • Paclitaxel oral solution will be administered orally at 100 mg/m² per dose three times weekly, on Monday, Wednesday, and Friday, approximately 1 hour after a meal.
    • For Paclitaxel oral solution, treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, or another protocol-defined discontinuation criterion. If dose reduction is required, the first reduced dose level will be 75 mg/m² per dose and the second reduced dose level will be 50 mg/m² per dose. Once the dose has been reduced, dose re-escalation will not be permitted.
  • PD-1/PD-L1 inhibitor (eg. Tislelizumab)Drug

    Also called Tislelizumab, Pembrolizumab, Camrelizumab, Penpulimab

    The appropriate PD-1/PD-L1 inhibitor will be selected by the investigator based on the patient's specific condition, eg. Tislelizumab, Pembrolizumab, Camrelizumab and Penpulimab, and its administration will strictly follow the dosing instructions provided in the relevant drug's package insert. The maintenance PD-1/PD-L1 inhibitor should generally be the same agent used during first-line induction treatment.

Study groups in NCT07744698
Study groupRoleWhat they receive
Cohort A: Advanced Squamous Non-Small Cell Lung Cancer(sqNSCLC)ExperimentalParticipants with histologically or cytologically confirmed, unresectable stage IIIB to IV squamous non-small cell lung cancer(sqNSCLC) who are not candidates for definitive chemoradiotherapy and who have completed four cycles of first-line treatment with a PD-1 or PD-L1 inhibitor, a platinum agent, and paclitaxel or nab-paclitaxel without disease progression will receive metronomic oral paclitaxel plus maintenance immune checkpoint inhibition.
Receives: Drug: Paclitaxel Oral Solution; Drug: PD-1/PD-L1 inhibitor (eg. Tislelizumab)
Cohort B: Extensive-Stage Small Cell Lung Cancer(ES-SCLC)ExperimentalParticipants with histologically or cytologically confirmed extensive-stage small cell lung cancer(ES-SCLC) who have completed four cycles of first-line treatment with a PD-1 or PD-L1 inhibitor, a platinum agent, and etoposide without disease progression will receive metronomic oral paclitaxel plus maintenance immune checkpoint inhibition.
Receives: Drug: Paclitaxel Oral Solution; Drug: PD-1/PD-L1 inhibitor (eg. Tislelizumab)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-Free Survival (PFS)

    PFS is defined as the time from the date of the first oral paclitaxel administration to the first occurrence of disease progression as determined by the investigator using RECIST v1.1 or death from any cause, whichever occurred first.

    Measured: First dose up to approximately 24 months

Secondary outcomes (8)
  1. Objective Response Rate(ORR)

    ORR is defined as the proportion of participants whose best overall response during maintenance treatment is a complete response (CR) or partial response (PR) as determined by the investigator using RECIST v1.1.

    Measured: First dose up to approximately 12 months

  2. 12-Week PFS rate

    The proportion of participants who are alive and have not experienced radiographic disease progression at 12 weeks after initiation of maintenance treatment.

    Measured: 12 weeks

  3. Disease Control Rate (DCR)

    DCR is defined as the proportion of participants whose best overall response during maintenance treatment is CR, PR or stable disease (SD) according to RECIST v1.1

    Measured: First dose up to approximately 12 months

  4. Duration of Response (DoR)

    DoR is defined for participants who achieve a CR or PR as the time from the first documented objective response to radiographic disease progression or death from any cause, whichever occurs first.

    Measured: First dose up to approximately 12 months

  5. Overall Survival (OS)

    OS is defined as the time from the first oral paclitaxel administration to death from any cause.

    Measured: First dose up to approximately 36 months

  6. Incidence of Adverse Events (AE)

    The number and proportion of participants experiencing treatment-emergent AEs (TEAE), serious AEs (SAE), treatment-related AEs (TRAE), grade 3 or higher AEs (AE), and AEs resulting in treatment interruption, dose reduction, permanent treatment discontinuation, hospitalization, or death. AE will be graded according to the CTCAE 5.0.

    Measured: First dose up to approximately 36 months

  7. Change From Baseline in Patient-Reported Lung Cancer Symptoms as Assessed by European Organization for the Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire-Core 30 (QLQ-C30) Symptom Score

    EORTC QLQ-C30 is a validated and reliable self-report measure that consists of 30 questions that assess five aspects of patient functioning (physical, emotional, role, cognitive, and social), three symptom scales (fatigue, nausea and vomiting, pain), global health/quality of life, and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). EORTC QLQ-C30 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life); however a high score for a symptom scale or item represents a high level of symptomatology or problems. A ≥10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al. 1998).

    Measured: Baseline, Week 6, Week 12, Week 24, every 12 weeks thereafter, and at the end-of-treatment visit, assessed up to 36 months

  8. Change From Baseline in Patient-Reported Lung Cancer Symptoms as Assessed by EORTC Quality-of-Life Lung Cancer Module (QLQ-LC13) Symptom Score

    The EORTC QLQ-LC13 module incorporates one multiple item scale to assess dyspnea and a series of single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. The EORTC QLQ-LC13 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life); however, a high score for a symptom scale or item represents a high level of symptomatology or problems. A≥10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al. 1998).

    Measured: Baseline and Weeks 6, 12, and 24, every 12 weeks thereafter, and at the end-of-treatment visit, up to 36 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Aug 2026
  2. Study start24 Jul 2026
  3. Primary completionJun 2029 (estimated)
  4. Study completionJun 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Participants will be assigned to one of two disease-specific cohorts according to tumor histology. Cohort A will include participants with advanced squamous non-small cell lung cancer(sqNSCLC), and Cohort B will include participants with extensive-stage small cell lung cancer(ES-SCLC). Both cohorts will receive the same maintenance strategy of metronomic oral paclitaxel plus a PD-1 or PD-L1 inhibitor. The cohorts will be analyzed independently, with no formal between-cohort efficacy comparison.
Masking
None (open label)
Enrolment
107 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07744698
Sponsor's protocol ID
2026-LLYJ-0070
Acronym
PULSE
Status last verified
Aug 2026
First submitted
29 Jul 2026
Last updated
4 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Individual participant-level data are not currently planned to be made publicly available. Aggregate study results may be presented at scientific meetings or published in peer-reviewed journals in accordance with applicable privacy, ethical, and institutional requirements.

Publications

  • Jin Li et al. Paclitaxel oral solution versus paclitaxel injection as second-line therapy in advanced gastric cancer: A randomized, open-label, non-inferiority phase 3 trial.JCO 42, 4051-4051(2024).

  • Nishio M, Barlesi F, West H, Ball S, Bordoni R, Cobo M, Longeras PD, Goldschmidt J Jr, Novello S, Orlandi F, Sanborn RE, Szalai Z, Ursol G, Mendus D, Wang L, Wen X, McCleland M, Hoang T, Phan S, Socinski MA. Atezolizumab Plus Chemotherapy for First-Line Treatment of Nonsquamous NSCLC: Results From the Randomized Phase 3 IMpower132 Trial. J Thorac Oncol. 2021 Apr;16(4):653-664. doi: 10.1016/j.jtho.2020.11.025. Epub 2020 Dec 14.

    PubMed 33333328
  • Brahmer J, Reckamp KL, Baas P, Crino L, Eberhardt WE, Poddubskaya E, Antonia S, Pluzanski A, Vokes EE, Holgado E, Waterhouse D, Ready N, Gainor J, Aren Frontera O, Havel L, Steins M, Garassino MC, Aerts JG, Domine M, Paz-Ares L, Reck M, Baudelet C, Harbison CT, Lestini B, Spigel DR. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med. 2015 Jul 9;373(2):123-35. doi: 10.1056/NEJMoa1504627. Epub 2015 May 31.

    PubMed 26028407
  • Ryu MH, Ryoo BY, Kim TW, Kim SB, Lim HS, Bae KS, Park SR, Jo YW, Cho HJ, Kang YK. A Phase I/IIa Study of DHP107, a Novel Oral Paclitaxel Formulation, in Patients with Advanced Solid Tumors or Gastric Cancer. Oncologist. 2017 Feb;22(2):129-e8. doi: 10.1634/theoncologist.2016-0273. Epub 2017 Feb 14.

    PubMed 28196905
  • Paz-Ares L, Vicente D, Tafreshi A, Robinson A, Soto Parra H, Mazieres J, Hermes B, Cicin I, Medgyasszay B, Rodriguez-Cid J, Okamoto I, Lee S, Ramlau R, Vladimirov V, Cheng Y, Deng X, Zhang Y, Bas T, Piperdi B, Halmos B. A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Protocol-Specified Final Analysis of KEYNOTE-407. J Thorac Oncol. 2020 Oct;15(10):1657-1669. doi: 10.1016/j.jtho.2020.06.015. Epub 2020 Jun 26.

    PubMed 32599071
  • Cheng Y, Fan Y, Zhao Y, Huang D, Li X, Zhang P, Kang M, Yang N, Zhong D, Wang Z, Yu Y, Zhang Y, Zhao J, Qin T, Chen C, Leaw S, Zheng W, Song Y; RATIONALE-312 Study Group. Tislelizumab Plus Platinum and Etoposide Versus Placebo Plus Platinum and Etoposide as First-Line Treatment for Extensive-Stage SCLC (RATIONALE-312): A Multicenter, Double-Blind, Placebo-Controlled, Randomized, Phase 3 Clinical Trial. J Thorac Oncol. 2024 Jul;19(7):1073-1085. doi: 10.1016/j.jtho.2024.03.008. Epub 2024 Mar 7.

    PubMed 38460751
  • Cheng Y, Han L, Wu L, Chen J, Sun H, Wen G, Ji Y, Dvorkin M, Shi J, Pan Z, Shi J, Wang X, Bai Y, Melkadze T, Pan Y, Min X, Viguro M, Li X, Zhao Y, Yang J, Makharadze T, Arkania E, Kang W, Wang Q, Zhu J; ASTRUM-005 Study Group. Effect of First-Line Serplulimab vs Placebo Added to Chemotherapy on Survival in Patients With Extensive-Stage Small Cell Lung Cancer: The ASTRUM-005 Randomized Clinical Trial. JAMA. 2022 Sep 27;328(12):1223-1232. doi: 10.1001/jama.2022.16464.

    PubMed 36166026
  • Wang J, Zhou C, Yao W, Wang Q, Min X, Chen G, Xu X, Li X, Xu F, Fang Y, Yang R, Yu G, Gong Y, Zhao J, Fan Y, Liu Q, Cao L, Yao Y, Liu Y, Li X, Wu J, He Z, Lu K, Jiang L, Hu C, Zhao W, Zhang B, Shi W, Zhang X, Cheng Y; CAPSTONE-1 Study Group. Adebrelimab or placebo plus carboplatin and etoposide as first-line treatment for extensive-stage small-cell lung cancer (CAPSTONE-1): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2022 Jun;23(6):739-747. doi: 10.1016/S1470-2045(22)00224-8. Epub 2022 May 13.

    PubMed 35576956
  • Paz-Ares L, Dvorkin M, Chen Y, Reinmuth N, Hotta K, Trukhin D, Statsenko G, Hochmair MJ, Ozguroglu M, Ji JH, Voitko O, Poltoratskiy A, Ponce S, Verderame F, Havel L, Bondarenko I, Kazarnowicz A, Losonczy G, Conev NV, Armstrong J, Byrne N, Shire N, Jiang H, Goldman JW; CASPIAN investigators. Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet. 2019 Nov 23;394(10212):1929-1939. doi: 10.1016/S0140-6736(19)32222-6. Epub 2019 Oct 4.

    PubMed 31590988
  • Horn L, Mansfield AS, Szczesna A, Havel L, Krzakowski M, Hochmair MJ, Huemer F, Losonczy G, Johnson ML, Nishio M, Reck M, Mok T, Lam S, Shames DS, Liu J, Ding B, Lopez-Chavez A, Kabbinavar F, Lin W, Sandler A, Liu SV; IMpower133 Study Group. First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer. N Engl J Med. 2018 Dec 6;379(23):2220-2229. doi: 10.1056/NEJMoa1809064. Epub 2018 Sep 25.

    PubMed 30280641
  • Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, Chirieac LR, Dacic S, Duhig E, Flieder DB, Geisinger K, Hirsch FR, Ishikawa Y, Kerr KM, Noguchi M, Pelosi G, Powell CA, Tsao MS, Wistuba I; WHO Panel. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol. 2015 Sep;10(9):1243-1260. doi: 10.1097/JTO.0000000000000630.

    PubMed 26291008
  • Zappa C, Mousa SA. Non-small cell lung cancer: current treatment and future advances. Transl Lung Cancer Res. 2016 Jun;5(3):288-300. doi: 10.21037/tlcr.2016.06.07.

    PubMed 27413711
  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.

    PubMed 33538338

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