• Lung Cancer Disease Site Group. Chemotherapy in stage IV (metastatic) non-small cell lung cancer. Toronto (ON): Cancer Care Ontario (CCO); 2005 Jan. 22 p. (Practice guideline report; no. 7-2). [28 references]

• Strong evidence including meta-analyses indicates that there is a small survival benefit of cisplatin-based chemotherapy over best supportive care in patients with non-small cell lung cancer and good performance status.
• If survival is the main outcome of interest for a patient, it is reasonable to offer chemotherapy to medically suitable patients as an option for this condition with a full discussion of the benefits, limitations, and toxicities.
• If symptom control and/or quality of life are the outcomes of interest for a patient, chemotherapy is a reasonable option which may improve quality of life and reduce disease-related symptoms.

None provided

Original Guideline: February 1996

There were three published meta-analyses available on this topic.

Update: January 2003

New evidence includes a meta-analysis, and eight randomized controlled trials comparing chemotherapy regimens (three platinum-based and five non-platinum-based) and best supportive care or palliative care with best supportive care or palliative care alone in patients with metastatic stage IV non-small cell lung cancer.

• Lung Cancer Disease Site Group. Chemotherapy in stage IV (metastatic) non-small cell lung cancer. Toronto (ON): Cancer Care Ontario (CCO); 2005 Jan. 22 p. (Practice guideline report; no. 7-2). [28 references]

Not applicable: The guideline was not adapted from another source.

1996 Feb 14 (revised 2005 Jan)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Provincial Lung Cancer Disease Site Group

Not stated

None available

This summary was completed by ECRI on January 5, 1999. The information was verified by the guideline developer as of February 22, 1999. This NGC summary was updated by ECRI on December 17, 2001. The updated information was verified by the guideline developer as of January 10, 2002. This summary was updated by ECRI on July 5, 2002. The updated information was verified by the guideline developer on August 19, 2002. This NGC summary was updated by ECRI on August 17, 2006. The updated information was verified by the guideline developer on August 23, 2006.