Cited by 850Lung Cancer Treatments and MutationsLung Cancer Diagnosis and TreatmentLung Cancer Research Studies
The DOI matches its Crossref record; 87 of the 176 references it cites were found in a registry or an index, and 88 are not checked yet; 1 of the 194 sources its claims cite were checked for support.
Systemic Therapy for Stage IV Non–Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update
Open accessMasters, Gregory A., Temin, Sarah, Azzoli, Christopher G., Giaccone, Giuseppe, Baker, Sherman, Brahmer, Julie R., Ellis, Peter M., Gajra, Ajeet, Rackear, Nancy, Schiller, Joan H., Smith, Thomas J., Strawn, John R., Trent, David, Johnson, David H.·2015·Journal of Clinical Oncology
Abstract
Purpose: To provide evidence-based recommendations to update the American Society of Clinical Oncology guideline on systemic therapy for stage IV non–small-cell lung cancer (NSCLC). Methods: An Update Committee of the American Society of Clinical Oncology NSCLC Expert Panel based recommendations on a systematic review of randomized controlled trials from January 2007 to February 2014. Results: This guideline update reflects changes in evidence since the previous guideline. Recommendations: There is no cure for patients with stage IV NSCLC. For patients with performance status (PS) 0 to 1 (and appropriate patient cases with PS 2) and without an EGFR-sensitizing mutation or ALK gene rearrangement, combination cytotoxic chemotherapy is recommended, guided by histology, with early concurrent palliative care. Recommendations for patients in the first-line setting include platinum-doublet therapy for those with PS 0 to 1 (bevacizumab may be added to carboplatin plus paclitaxel if no contraindications); combination or single-agent chemotherapy or palliative care alone for those with PS 2; afatinib, erlotinib, or gefitinib for those with sensitizing EGFR mutations; crizotinib for those with ALK or ROS1 gene rearrangement; and following first-line recommendations or using platinum plus etoposide for those with large-cell neuroendocrine carcinoma. Maintenance therapy includes pemetrexed continuation for patients with stable disease or response to first-line pemetrexed-containing regimens, alternative chemotherapy, or a chemotherapy break. In the second-line setting, recommendations include docetaxel, erlotinib, gefitinib, or pemetrexed for patients with nonsquamous cell carcinoma; docetaxel, erlotinib, or gefitinib for those with squamous cell carcinoma; and chemotherapy or ceritinib for those with ALK rearrangement who experience progression after crizotinib. In the third-line setting, for patients who have not received erlotinib or gefitinib, treatment with erlotinib is recommended. There are insufficient data to recommend routine third-line cytotoxic therapy. Decisions regarding systemic therapy should not be made based on age alone. Additional information can be found at http://www.asco.org/guidelines/nsclc and http://www.asco.org/guidelineswiki .
Verified 2026-10-06 · 88 references not checked yet
Overview
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Written from the paper’s full text.
TL;DR
This ASCO guideline update provides evidence-based recommendations for systemic therapy in stage IV NSCLC, based on a systematic review of 87 publications covering 73 phase III randomized controlled trials. It stratifies treatment by histology, molecular subtype (EGFR, ALK, ROS1), and performance status, and emphasizes concurrent palliative care and that age alone should not determine therapy.
Key findings
- There is no cure for stage IV NSCLC; for patients with PS 0–1 (and appropriate PS 2) without EGFR-sensitizing mutation or ALK rearrangement, platinum-based combination cytotoxic chemotherapy guided by histology plus early concurrent palliative care is recommended (evidence quality high; strength strong).
- For sensitizing EGFR mutations, afatinib, erlotinib, or gefitinib are recommended (each evidence quality high; strength strong); for ALK rearrangement, first-line crizotinib is recommended (evidence quality high; strength strong); for ROS1 rearrangement, crizotinib is recommended by informal consensus (evidence quality low; strength weak).
- Maintenance: pemetrexed continuation is recommended for stable disease or response after four cycles of a pemetrexed-containing regimen (PARAMOUNT: PFS 4.4 v 2.8 months; OS 13.9 v 11 months, unadjusted HR P = .019).
- Second-line options: docetaxel, erlotinib, gefitinib, or pemetrexed for nonsquamous; docetaxel, erlotinib, or gefitinib for squamous; chemotherapy or ceritinib after progression on crizotinib for ALK rearrangement. Third-line erlotinib may be recommended for patients who have not received erlotinib or gefitinib; data are insufficient for routine third-line cytotoxic therapy.
- Decisions on chemotherapy should not be made based on age alone (evidence quality high; strength strong); the IFCT-0501 trial in elderly patients showed median OS 10.3 v 6.2 months favoring carboplatin plus paclitaxel over monotherapy (HR, 0.64; P < .001).
Methods
- An ASCO Update Committee developed recommendations based on a systematic review of phase III RCTs; PubMed was searched from January 2007 to February 2014 for non–switch maintenance questions and June 2009 to February 2014 for switch maintenance questions.
- Inclusion criteria: population with stage IV NSCLC (many trials also included stage IIIB) and fully published English-language phase III RCTs; exclusions included meeting abstracts not subsequently published, editorials/commentaries/case reports/narrative reviews, and non-English publications.
- A total of 87 publications concerning 73 phase III RCTs formed the evidence base (51 trials in first-line/maintenance settings, 22 in second-/third-line); recommendations were crafted using GLIDES methodology and BRIDGE-Wiz software, with ratings for type, strength, evidence quality, and potential bias; informal consensus was used where evidence was lacking but committee agreement was high.
Limitations
- Stated: insufficient objective tools to determine which patients benefit from and tolerate combined versus single-agent chemotherapy; insufficient data for patients with PS 2; not enough data on large-cell neuroendocrine carcinoma, on ROS1 and crizotinib, on second-line treatment after first-line EGFR TKI progression or after initial response, and immature data on adding pemetrexed to bevacizumab plus carboplatin (only one phase III trial).
- Stated: quality assessment indicated intermediate to high potential risk of bias for most identified evidence, with some factors varying between studies and lowering comparability of results.
- Evident from the text: several recommendations rest on informal consensus or low-quality evidence (ROS1 rearrangement, large-cell neuroendocrine carcinoma, second-line after EGFR TKI progression), and some cited evidence (e.g., ceritinib, nivolumab, PROFILE 1014) was published after the systematic review's data cutoff or fell outside its date parameters.
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Integrity signals
Registry
Crossref · 10.1200/jco.2015.62.1342
Cites
87 of 175 references verified0 citation errors · 0 not checkable
Statistics
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Verification
Claims the paper makes
154 Not checked yet · 29 No basis given · 23 Own interpretation · 12 Own result · 11 Own method · 1 Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In the group of 80 patients who had received crizotinib, median PFS was 6.9 months (95% CI, 5.3 to 8.8).”
What the sources say
- Supportedcites [42] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–1197. doi: 10.1056/NEJMoa1311107. [DOI] [PMC free article] [PubMed] [Google Scholar] source
The Results > Efficacy passage reports a median progression-free survival of 6.9 months (95% CI, 5.3 to 8.8) in 80 patients with NSCLC who had previously received crizotinib. This matches the cited claim. (LLM, conf=0.95)
plainn = 80- Asserted: passes — The authors put it forward as true.
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- Supported
None of the sources cited for this claim have been checked yet.
In the paper
“Two trials reported significant differences for OS or median survival.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Fifteen trials reported significant differences for PFS or TTP.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Six trials reported significant differences for OS or median survival.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 87 publications concerning 73 phase III RCTs met the systematic review eligibility criteria and form the evidentiary basis for the guideline recommendations.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“no statistically significant differences in OS with chemotherapy”
What the sources say
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“adverse events occurred at a higher frequency with carboplatin plus paclitaxel.”
What the sources say
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There were 22 trials of second- and third-line therapies;”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In the study by Maemondo et al,20 this regimen resulted in poorer outcomes in PFS and TTP and no statistically significant differences in OS with chemotherapy; adverse events occurred at a higher frequency with carboplatin plus paclitaxel.”
What the sources say
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Eighteen trials reported significant differences for PFS or time to progression (TTP).”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“They also experienced more thrombocytopenia (46% v 36%; P = .03).”
What the sources say
- Not checked yetcites [19] Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer. 2010;46:2225–2234. doi: 10.1016/j.ejca.2010.04.009. [DOI] [PubMed] [Google Scholar] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“one trial that included cisplatin plus docetaxel in the control arm and did not find the intervention arm to be superior (intravenous vinorelbine and oral vinorelbine plus cisplatin).69”
What the sources say
- Not checked yetcites [69] Tan EH, Rolski J, Grodzki T, et al. Global Lung Oncology Branch Trial 3 (GLOB3): Final results of a randomised multinational phase III study alternating oral and i.v. vinorelbine plus cisplatin versus docetaxel plus cisplatin as first-line treatment of advanced non-small-cell lung cancer. Ann Oncol. 2009;20:1249–1256. doi: 10.1093/annonc/mdn774. [DOI] [PubMed] [Google Scholar] source
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In the paper
“A major gap in current evidence is a lack of direct comparisons of platinum plus pemetrexed with or without bevacizumab.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“As with the cisplatin regimens, none of the carboplatin regimens listed have shown clear superiority over the others.”
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“QoL was also better; however, the trial had low accrual and was stopped early58”
What the sources say
- Not checked yetcites [58] Morabito A, Gebbia V, Di Maio M, et al. Randomized phase III trial of gemcitabine and cisplatin vs. gemcitabine alone in patients with advanced non-small cell lung cancer and a performance status of 2: The CAPPA-2 study. Lung Cancer. 2013;81:77–83. doi: 10.1016/j.lungcan.2013.04.008. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty6,13,18,27,28,34,36,38,39,44,52,53,55,58,70,79–82 of 44 new first-line studies in the updated systematic review included patients with PS 2.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A second trial33 compared maintenance pemetrexed plus bevacizumab with bevacizumab alone (after first-line induction with bevacizumab, cisplatin, and pemetrexed). The study met its primary end point of statistically significantly longer PFS with bevacizumab plus pemetrexed (7.4 v 3.7 months; hazard ratio [HR], 0.48; 95% CI, 0.35 to 0.66; P < .001).”
What the sources say
- Not checked yetcites [33] Barlesi F, Scherpereel A, Rittmeyer A, et al. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non–small-cell lung cancer: AVAPERL (MO22089) J Clin Oncol. 2013;31:3004–3011. doi: 10.1200/JCO.2012.42.3749. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Survival was not significantly longer (16.6 v 14.8 months).”
What the sources say
- Not checked yetcites [86] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“At the time of study publication, OS had not yet been reached.”
What the sources say
- Not checked yetcites [33] Barlesi F, Scherpereel A, Rittmeyer A, et al. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non–small-cell lung cancer: AVAPERL (MO22089) J Clin Oncol. 2013;31:3004–3011. doi: 10.1200/JCO.2012.42.3749. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Patients with PS 2 make up fewer than half of patients enrolled onto clinical trials.84”
What the sources say
- Not checked yetcites [84] Sargent DJ, Köhne CH, Sanoff HK, et al. Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer. J Clin Oncol. 2009;27:1948–1955. doi: 10.1200/JCO.2008.20.2879. [DOI] [PMC free article] [PubMed] [Google Scholar] source
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In the paper
“Since the publication of the ASCO 2009 guideline and the ASCO EGFR provisional clinical opinion,59 results from seven trials of first-line EGFR TKIs for patients with EGFR mutations have been published.11,13,29,31,34,36,40”
What the sources say
- Not checked yetcites [11] Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31:3327–3334. doi: 10.1200/JCO.2012.44.2806. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [13] Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12:735–742. doi: 10.1016/S1470-2045(11)70184-X. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [29] Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): A multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13:239–246. doi: 10.1016/S1470-2045(11)70393-X. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“there were fewer adverse effects (eg, neuropathy) without the platinum agent.”
What the sources say
- Not checked yetcites [73] Treat JA, Gonin R, Socinski MA, et al. A randomized, phase III multicenter trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin in patients with advanced or metastatic non-small-cell lung cancer. Ann Oncol. 2010;21:540–547. doi: 10.1093/annonc/mdp352. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“An interim analysis found a median OS of 20.3 months (95% CI, 18.1 to not reached) for crizotinib versus 22.8 months (95% CI, 18.6 to not reached) for chemotherapy (HR, 1.02; 95% CI, 0.68 to 1.54; P = .54).”
What the sources say
- Not checked yetcites [56] Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368:2385–2394. doi: 10.1056/NEJMoa1214886. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Survival was not significantly different (P = .36).”
What the sources say
- Not checked yetcites [54] Solomon BJ, Mok T, Kim DW, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med. 2014;371:2167–2177. doi: 10.1056/NEJMoa1408440. [DOI] [PubMed] [Google Scholar] source
plainn = 343- Asserted: passes — The authors put it forward as true.
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In the paper
“Another trial, in which vinorelbine plus gemcitabine followed by docetaxel was compared with carboplatin plus paclitaxel, found that OS and PFS were not statistically significantly different for efficacy, although the response rate was higher with carboplatin plus paclitaxel; each regimen had different toxicity rates that were higher than the other.74”
What the sources say
- Not checked yetcites [74] Kubota K, Kawahara M, Ogawara M, et al. Vinorelbine plus gemcitabine followed by docetaxel versus carboplatin plus paclitaxel in patients with advanced non-small-cell lung cancer: A randomised, open-label, phase III study. Lancet Oncol. 2008;9:1135–1142. doi: 10.1016/S1470-2045(08)70261-4. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The PFS results were 7.7 months (95% CI, 6.0 to 8.8) with crizotinib compared with 3.0 months (95% CI, 2.6 to 4.3) with chemotherapy (HR, 0.49; 95% CI, 0.37 to 0.64; P < .001).”
What the sources say
- Not checked yetcites [56] Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368:2385–2394. doi: 10.1056/NEJMoa1214886. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In a trial comparing docetaxel plus gemcitabine with docetaxel alone, the OS results showed a statistically significant difference of 1.1 months in favor of the doublet; the study was closed prematurely.52”
What the sources say
- Not checked yetcites [52] Georgoulias V, Androulakis N, Kotsakis A, et al. Docetaxel versus docetaxel plus gemcitabine as front-line treatment of patients with advanced non-small cell lung cancer: A randomized, multicenter phase III trial. Lung Cancer. 2008;59:57–63. doi: 10.1016/j.lungcan.2007.07.021. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The updated systematic review identified two small trials specifically comparing single agent versus combination chemotherapy in patients with PS 2.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In the updated systematic review, in the three-arm study by Treat et al,73 although efficacy did not differ between the two platinum-containing arms and the paclitaxel plus gemcitabine arm, there were fewer adverse effects (eg, neuropathy) without the platinum agent.”
What the sources say
- Not checked yetcites [73] Treat JA, Gonin R, Socinski MA, et al. A randomized, phase III multicenter trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin in patients with advanced or metastatic non-small-cell lung cancer. Ann Oncol. 2010;21:540–547. doi: 10.1093/annonc/mdp352. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In one small study, there was a PFS benefit with erlotinib (9.7 v 5.2 months; HR, 0.37; 95% CI, 0.25 to 0.54; P < .001); OS had not been reached by the time of publication.29”
What the sources say
- Not checked yetcites [29] Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): A multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13:239–246. doi: 10.1016/S1470-2045(11)70393-X. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“One study, with PFS as primary outcome, compared first-line afatinib with cisplatin plus pemetrexed. The results showed improvement with afatinib (11.1 v 6.9 months; HR, 0.58; 95% CI, 0.43 to 0.78; P = .001).”
What the sources say
- Not checked yetcites [86] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A prespecified analysis of patients with these common mutations showed a PFS of 13.6 versus 6.9 months for chemotherapy (HR, 0.47; 95% CI, 0.34 to 0.65; P = .001).11”
What the sources say
- Not checked yetcites [11] Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31:3327–3334. doi: 10.1200/JCO.2012.44.2806. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is no evidence of any differential effect of histology on treatment for nonplatinum combinations.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“One trial of two different doses of bevacizumab in combination with cisplatin plus gemcitabine versus a placebo provided updated OS results (earlier results were reviewed in 2009 guideline). The results were not statistically significantly different and therefore do not provide support for changing the current recommendation.76”
What the sources say
- Not checked yetcites [76] Reck M, von Pawel J, Zatloukal P, et al. Overall survival with cisplatin-gemcitabine and bevacizumab or placebo as first-line therapy for nonsquamous non-small-cell lung cancer: Results from a randomised phase III trial (AVAiL) Ann Oncol. 2010;21:1804–1809. doi: 10.1093/annonc/mdq020. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The trial by Scagliotti et al68 comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed demonstrated improved OS for patients with SCC treated with cisplatin plus gemcitabine.”
What the sources say
- Not checked yetcites [68] Scagliotti GV, Parikh P, von Pawel J, 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;26:3543–3551. doi: 10.1200/JCO.2007.15.0375. [DOI] [PubMed] [Google Scholar] source
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“although the response rate was higher with carboplatin plus paclitaxel”
What the sources say
- Not checked yetcites [74] Kubota K, Kawahara M, Ogawara M, et al. Vinorelbine plus gemcitabine followed by docetaxel versus carboplatin plus paclitaxel in patients with advanced non-small-cell lung cancer: A randomised, open-label, phase III study. Lancet Oncol. 2008;9:1135–1142. doi: 10.1016/S1470-2045(08)70261-4. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“This trial of 343 participants reached its primary end point of higher PFS with crizotinib (10.9 v 7 months; HR, 0.454; 95% CI, 0.346 to 0.596; P < .001).”
What the sources say
- Not checked yetcites [54] Solomon BJ, Mok T, Kim DW, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med. 2014;371:2167–2177. doi: 10.1056/NEJMoa1408440. [DOI] [PubMed] [Google Scholar] source
plaindirectn = 343- Asserted: passes — The authors put it forward as true.
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In the paper
“A retrospective review of trials of antimicrotubule plus platinum chemotherapy conducted by SWOG reported no differential effect of histology on treatment.85”
What the sources say
- Not checked yetcites [85] Chansky K, Mack P, Crowley J, et al. Chemotherapy outcomes by histologic subtype of non-small cell lung cancer (NSCLC): Analysis of the SWOG database for antimicrotubule-platinum therapy. J Thorac Oncol. 2009;4(suppl 1) doi: 10.1016/j.cllc.2013.06.010. abstr B2.7. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The Cochrane systematic review on chemotherapy and supportive care, updated in 2012, continued to show that chemotherapy and best supportive care versus supportive care alone benefit patients, including those who have PS 2.83”
What the sources say
- Not checked yetcites [83] Non-Small Cell Lung Cancer Collaborative Group. Chemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer. Cochrane Database Syst Rev. 2010;5:CD007309. doi: 10.1002/14651858.CD007309.pub2. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“In the second small study, which was a publication of an abstract in the provisional clinical opinion, there was a longer PFS (erlotinib: 13.7 months; 95% CI, 10.6 to 15.3; control: 4.6 months; 95% CI, 4.2 to 5.4; HR, 0.164; 95% CI, 0.11 to 0.26; P < .001); OS had not yet been reached.13,14”
What the sources say
- Not checked yetcites [13] Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12:735–742. doi: 10.1016/S1470-2045(11)70184-X. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [14] Chen G, Feng J, Zhou C, et al. Quality of life (QoL) analyses from OPTIMAL (CTONG-0802), a phase III, randomised, open-label study of first-line erlotinib versus chemotherapy in patients with advanced EGFR mutation-positive non-small-cell lung cancer (NSCLC) Ann Oncol. 2013;24:1615–1622. doi: 10.1093/annonc/mdt012. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Most of the trials evaluating chemotherapy options in the first-line setting did not report any differential efficacy in patients with SCC.”
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are no results from direct comparative trials of different EGFR TKIs.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A statistically significant PFS was found for all patients in the trial treated with gefitinib, including those whose tumors were EGFR mutation positive.61”
What the sources say
- Not checked yetcites [61] Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361:947–957. doi: 10.1056/NEJMoa0810699. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“ALK gene rearrangements are identified in a small proportion of newly diagnosed patients with NSCLC (approximately 5%).77,87–89”
What the sources say
- Not checked yetcites [77] Blackhall F, Peters S, Kerr Kea. Prevalence and cinical outcomes for patients with ALK gene rearrangment in Europe: Preliminary results for the European Thoracic Oncology Platform Lungscape Project. Ann Oncol. 2012;23:ix73–ix94. abstr 1670. [Google Scholar] source
- Not checked yetcites [87] Soda M, Choi YL, Enomoto M, et al. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature. 2007;448:561–566. doi: 10.1038/nature05945. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [88] Rikova K, Guo A, Zeng Q, et al. Global survey of phosphotyrosine signaling identifies oncogenic kinases in lung cancer. Cell. 2007;131:1190–1203. doi: 10.1016/j.cell.2007.11.025. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [89] Camidge DR, Doebele RC. Treating ALK-positive lung cancer: Early successes and future challenges. Nat Rev Clin Oncol. 2012;9:268–277. doi: 10.1038/nrclinonc.2012.43. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A study78 was published after the close of the date parameters for the systematic review that included 50 patients from a second-line crizotinib trial who had ROS1 rearrangements.”
What the sources say
- Not checked yetcites [78] Shaw AT, Ou SH, Bang YJ, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014;371:1963–1971. doi: 10.1056/NEJMoa1406766. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 50- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This recommendation does not include gemcitabine as an option, because evidence was not found in the systematic review.”
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“An early clinical trial showed a benefit for ramucirumab when administered with docetaxel compared with docetaxel alone, with a 1.4-month OS advantage.”
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most second-line studies in this systematic review included patients with SCC.”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most of the trials in the systematic review did not find differences between the four agents that this guideline presents as second-line options.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, the OS of patients with PS 2 was inferior to that of patients with PS 0 to 1 in multivariable analysis.”
What the sources say
- Not checked yetcites [53] Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011;378:1079–1088. doi: 10.1016/S0140-6736(11)60780-0. [DOI] [PubMed] [Google Scholar] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Median duration of response was 17.6 months (95% CI, 14.5 to not reached).”
What the sources say
- Not checked yetcites [78] Shaw AT, Ou SH, Bang YJ, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014;371:1963–1971. doi: 10.1056/NEJMoa1406766. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 50- Asserted: passes — The authors put it forward as true.
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In the paper
“The participants who received chemotherapy experienced longer OS compared with those who received erlotinib (8.2 v 5.4 months; P = .10).”
What the sources say
- Not checked yetcites [41] Garassino MC, Martelli O, Broggini M, et al. Erlotinib versus docetaxel as second-line treatment of patients with advanced non-small-cell lung cancer and wild-type EGFR tumours (TAILOR): A randomised controlled trial. Lancet Oncol. 2013;14:981–988. doi: 10.1016/S1470-2045(13)70310-3. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“However, multiple trials did not identify age as a pretreatment risk factor for either tolerance or response to treatment with cytotoxic therapy.1”
What the sources say
- Not checked yetcites [1] Azzoli CG, Baker S, Jr, Temin S, et al. American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV non–small-cell lung cancer. J Clin Oncol. 2009;27:6251–6266. doi: 10.1200/JCO.2009.23.5622. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The studies found in the current systematic review included the French multicenter randomized phase III trial Intergroupe Francophone de Cancérologie Thoracique (IFCT) 0501,53 the largest prospective trial to successfully compare a platinum-based combination regimen with single-agent chemotherapy in an elderly population.”
What the sources say
- Not checked yetcites [53] Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011;378:1079–1088. doi: 10.1016/S0140-6736(11)60780-0. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Adverse events were not uniformly less common in one arm versus the other.67”
What the sources say
- Not checked yetcites [67] Pallis AG, Agelaki S, Agelidou A, et al. A randomized phase III study of the docetaxel/carboplatin combination versus docetaxel single-agent as second line treatment for patients with advanced/metastatic non-small cell lung cancer. BMC Cancer. 2010;10:633. doi: 10.1186/1471-2407-10-633. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given that there were no data meeting the inclusion criteria to inform this question, the Update Committee relied on clinical experience, training, and judgment to formulate this recommendation.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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- The authors state this as an assumption: For recommendations B3.a and B3.b, clinical experience, training, and judgment are sufficient to formulate recommendations when no data meet inclusion criteria.
None of the sources cited for this claim have been checked yet.
In the paper
“OS was 2.9 months longer (13.9 v 11 months; unadjusted HR P = .019).”
What the sources say
- Not checked yetcites [7] Paz-Ares LG, de Marinis F, Dediu M, 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;31:2895–2902. doi: 10.1200/JCO.2012.47.1102. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [8] Paz-Ares L, de Marinis F, Dediu M, 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;13:247–255. doi: 10.1016/S1470-2045(12)70063-3. [DOI] [PubMed] [Google Scholar] source
plaindirectn = 539 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Median PFS was 19.2 months (95% CI, 14.4 to not reached).”
What the sources say
- Not checked yetcites [78] Shaw AT, Ou SH, Bang YJ, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014;371:1963–1971. doi: 10.1056/NEJMoa1406766. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Given that there were no data meeting the inclusion criteria to inform this question, the Update Committee relied on clinical experience, training, and judgment to formulate this recommendation.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: For recommendations B3.a and B3.b, clinical experience, training, and judgment are sufficient to formulate recommendations when no data meet inclusion criteria.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“there some evidence that continued chemotherapy may do harm, including the foregoing of advance care planning, palliative care consultation, and early use of hospice.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is no high-level evidence to guide the physician or patient in this situation.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“In distinction from chemotherapy after the second-line setting, palliative care has been associated with equal103–106 or longer107–109 survival in randomized and nonrandomized110 trials of patients with advanced cancer.”
What the sources say
- Not checked yetcites [103] Gade G, Venohr I, Conner D, et al. Impact of an inpatient palliative care team: A randomized control trial. J Palliat Med. 2008;11:180–190. doi: 10.1089/jpm.2007.0055. [DOI] [PubMed] [Google Scholar]
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plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the intervening years, this method of assessing EGFR expression has not been shown to be feasible.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is a lack of conclusive data for treating this population, especially with a second TKI.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There was crossover in this study, so the authors could not analyze the association of mutation status with OS.”
What the sources say
- Not checked yetcites [102] Gridelli C, Maione P, Rossi A. The PARAMOUNT trial: A phase III randomized study of maintenance pemetrexed versus placebo immediately following induction first-line treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small cell lung cancer. Rev Recent Clin Trials. 2013;8:23–28. doi: 10.2174/15748871112079990040. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are no data that suggest a benefit to additional chemotherapy compared with alternative forms of non–chemotherapy-based care, such as hospice or palliative care.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Some of the second-line studies included patients who had received > two previous regimens.15,23,47,48,51,65”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
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- Not checked yetcites [47] Lee DH, Park K, Kim JH, et al. Randomized phase III trial of gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received platinum-based chemotherapy. Clin Cancer Res. 2010;16:1307–1314. doi: 10.1158/1078-0432.CCR-09-1903. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Given that there are no data to suggest that patients with EGFR mutations for whom EGFR TKIs fail do poorly with chemotherapy, the Update Committee opted to make a consensus recommendation for chemotherapy as a second-line treatment.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are no data to suggest that the benefits of continued chemotherapy outweigh the risks”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There are no published phase III trials on ceritinib (or other studies that met inclusion criteria for this systematic review).”
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In the paper
“There have been no prospective, randomized studies investigating the efficacy of second-line chemotherapy in patients with EGFR mutations who have responded to a first-line EGFR TKI.”
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In the paper
“The results show that disparities in race,128–131 sex,132 socioeconomic status,132–135 level of education,136 residence,128,136 and insurance status,137–139 among other factors, continue to be associated with outcomes such as mortality,128,140 incidence,137,140 stage at diagnosis, and timely receipt of recommended treatment129,131 for patients with NSCLC.”
What the sources say
- Not checked yetcites [128] Hayanga AJ, Zeliadt SB, Backhus LM. Residential segregation and lung cancer mortality in the United States. JAMA Surg. 2013;148:37–42. doi: 10.1001/jamasurgery.2013.408. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [129] Bryant AS, Cerfolio RJ. Impact of race on outcomes of patients with non-small cell lung cancer. J Thorac Oncol. 2008;3:711–715. doi: 10.1097/JTO.0b013e31817c60c7. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [130] Bergamo C, Lin JJ, Smith C, et al. Evaluating beliefs associated with late-stage lung cancer presentation in minorities. J Thorac Oncol. 2013;8:12–18. doi: 10.1097/JTO.0b013e3182762ce4. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [131] Shugarman LR, Mack K, Sorbero ME, et al. Race and sex differences in the receipt of timely and appropriate lung cancer treatment. Med Care. 2009;47:774–781. doi: 10.1097/MLR.0b013e3181a393fe. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [132] Hardy D, Liu CC, Xia R, et al. Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. Cancer. 2009;115:2199–2211. doi: 10.1002/cncr.24248. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [137] Slatore CG, Au DH, Gould MK. An official American Thoracic Society systematic review: Insurance status and disparities in lung cancer practices and outcomes. Am J Respir Crit Care Med. 2010;182:1195–1205. doi: 10.1164/rccm.2009-038ST. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [138] Rasco DW, Yan J, Xie Y, et al. Looking beyond Surveillance, Epidemiology, and End Results: Patterns of chemotherapy administration for advanced non-small cell lung cancer in a contemporary, diverse population. J Thorac Oncol. 2010;5:1529–1535. doi: 10.1097/JTO.0b013e3181e9a00f. [DOI] [PMC free article] [PubMed] [Google Scholar] source
- Not checked yetcites [139] Mack JW, Chen K, Boscoe FP, et al. Underuse of hospice care by Medicaid-insured patients with stage IV lung cancer in New York and California. J Clin Oncol. 2013;31:2569–2579. doi: 10.1200/JCO.2012.45.9271. [DOI] [PMC free article] [PubMed] [Google Scholar]
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In the paper
“Most available data regarding MCCs in advanced NSCLC are collected and reported as comorbidity.19”
What the sources say
- Not checked yetcites [19] Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer. 2010;46:2225–2234. doi: 10.1016/j.ejca.2010.04.009. [DOI] [PubMed] [Google Scholar] source
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In the paper
“The data informing chemotherapy decisions for patients with PS 2 are insufficient.”
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In the paper
“Although there have been several therapeutic trials in advanced NSCLC that have been limited to these populations, few have reported the specific association of MCCs with toxicity and efficacy of treatment as a distinct end point.”
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In the paper
“There are few data regarding the impact of specific chronic conditions on outcomes (chemotherapy-related adverse events and survival) in advanced NSCLC.”
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In the paper
“it lacked the power to determine an OS difference.71”
What the sources say
- Not checked yetcites [71] Lynch TJ, Patel T, Dreisbach L, et al. Cetuximab and first-line taxane/carboplatin chemotherapy in advanced non–small-cell lung cancer: Results of the randomized multicenter phase III trial BMS099. J Clin Oncol. 2010;28:911–917. doi: 10.1200/JCO.2009.21.9618. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Combination therapy improves outcomes for patients with PS 0 to 1 and appropriate patients with PS 2 who are willing to accept the potential risks and is therefore recommended by the Update Committee.”
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In the paper
“An Update Committee of the American Society of Clinical Oncology NSCLC Expert Panel based recommendations on a systematic review of randomized controlled trials from January 2007 to February 2014.”
- Also stated in: § METHODS · plain
“The recommendations were developed by an Update Committee with multidisciplinary representation using a systematic review of phase III RCTs and clinical experience.”
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- Also stated in: § METHODS · plain
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In the paper
“Two-drug combinations were superior to single-agent therapy, platinum-based two-drug combinations were slightly superior to nonplatinum combinations in meta-analysis, and cisplatin was slightly superior in efficacy to carboplatin in meta-analysis but perhaps not worth the added toxicity in the palliative care setting.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Two-drug combinations were superior to single-agent therapy, platinum-based two-drug combinations were slightly superior to nonplatinum combinations in meta-analysis, and cisplatin was slightly superior in efficacy to carboplatin in meta-analysis but perhaps not worth the added toxicity in the palliative care setting.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“the combination of cisplatin and pemetrexed is superior to that of cisplatin and gemcitabine in NSCC.”
What the sources say
- Not checked yetcites Scagliotti et al68
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“addition of bevacizumab to carboplatin and paclitaxel improves OS in select patients with NSCC”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Two-drug combinations were superior to single-agent therapy, platinum-based two-drug combinations were slightly superior to nonplatinum combinations in meta-analysis, and cisplatin was slightly superior in efficacy to carboplatin in meta-analysis but perhaps not worth the added toxicity in the palliative care setting.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There is overwhelming and consistent evidence now from multiple trials that gefitinib, erlotinib, or afatinib have greater activity than platinum-based chemotherapy in the first-line treatment of patients with advanced NSCLC with activating EGFR mutations.”
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“There were no compelling data regarding any single regimen for this population; therefore, clinical judgment should guide the choice of therapy among regimens.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The availability of these agents and companion diagnostics now makes testing for these mutations a new standard of care.3”
What the sources say
- Not checked yetcites [3] Leighl NB, Rekhtman N, Biermann WA, et al. Molecular testing for selection of patients with lung cancer for epidermal growth factor receptor and anaplastic lymphoma kinase tyrosine kinase inhibitors: American Society of Clinical Oncology endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology guideline. J Clin Oncol. 2014;32:3673–3679. doi: 10.1200/JCO.2014.57.3055. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The results of this trial suggest that a platinum agent plus pemetrexed should not be administered in patients with SCC, and in fact, licensing in many health care jurisdictions limits the use of pemetrexed for patients with nonsquamous histology.”
What the sources say
- Not checked yetcites [68] Scagliotti GV, Parikh P, von Pawel J, 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;26:3543–3551. doi: 10.1200/JCO.2007.15.0375. [DOI] [PubMed] [Google Scholar] source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The data informing chemotherapy decisions for patients with PS 2 are insufficient to make a strong recommendation favoring combination chemotherapy.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“None of the trials found provide support for adding bevacizumab to chemotherapy regimens other than carboplatin plus paclitaxel.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The Update Committee believes that carboplatin plus paclitaxel is the only regimen for which the data support the addition of bevacizumab.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“As of the 2011 guideline update, evidence of improvements in OS and PFS with the addition of bevacizumab to carboplatin plus paclitaxel supported the affirmative recommendation for this combination for patients meeting certain criteria, especially the criterion of having NSCC.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Since the systematic review was performed for this guideline, nivolumab has emerged for patients with SCC in the second- and third-line settings who experience progression during or after platinum-based therapy.100”
What the sources say
- Not checked yetcites [100] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The primary end point was overall response rate, which occurred in 17 (14.5%) of 117 patients (95% CI 8.7 to 22.2).”
What the sources say
- Not checked yetcites [98] Rizvi NA, Mazières J, Planchard D, et al. Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small-cell lung cancer (CheckMate 063): A phase 2, single-arm trial. Lancet Oncol. 2015;16:257–265. doi: 10.1016/S1470-2045(15)70054-9. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 117- Asserted: passes — The authors put it forward as true.
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In the paper
“Median OS was 9.2 versus 6 months, favoring nivolumab (HR, 0.59; 95% CI, 0.44 to 0.79; P < .001).”
What the sources say
- Not checked yetcites [101] Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373:123–135. doi: 10.1056/NEJMoa1504627. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plaindirectn = 272- Asserted: passes — The authors put it forward as true.
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In the paper
“Clinical trials support the use of single-agent therapy for patients with relapsed nonsquamous NSCLC after first-line chemotherapy.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“On March 14, 2015, the FDA approved nivolumab for the treatment of patients with metastatic squamous cell NSCLC with disease progression who had received ≥ one prior platinum-based regimen”
What the sources say
- Not checked yetcites [101] Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373:123–135. doi: 10.1056/NEJMoa1504627. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 272- Asserted: passes — The authors put it forward as true.
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In the paper
“Because there is evidence that pemetrexed is less effective for patients whose tumors have SCC histology, pemetrexed is included only in the NSCC recommendation (Recommendation B1).”
What the sources say
- Not checked yetcites Scagliotti et al68
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“On December 12, 2014, the FDA approved ramucirumab for use in combination with docetaxel for the treatment of patients with metastatic NSCLC who experience disease progression during or after platinum-based chemotherapy”
What the sources say
- Not checked yetcites 97a
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Sixty-three percent of the patients in the afatinib group and 76% in the control group received ≥ one subsequent regimen (all mutation statuses).15”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Of patients with EGFR mutation–positive NSCLC who were randomly assigned to carboplatin plus paclitaxel, 64.3% subsequently received EGFR TKIs.”
What the sources say
- Not checked yetcites [30] Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS) J Clin Oncol. 2011;29:2866–2874. doi: 10.1200/JCO.2010.33.4235. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“current FDA approval allows for initial therapy with crizotinib for patients with stage IV NSCLC harboring ALK mutations (see Recommendation A5).”
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Other studies have randomly assigned patients with EGFR mutations to a first-line EGFR TKI or cytotoxic chemotherapy and found that PFS was improved in those who received the EGFR TKI.”
What the sources say
- Not checked yetcites [11] Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31:3327–3334. doi: 10.1200/JCO.2012.44.2806. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [13] Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12:735–742. doi: 10.1016/S1470-2045(11)70184-X. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Response rate was 7% versus 0.5%.”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Among these 96 patients, PFS was 3.3 months for those who received afatinib and 1.0 month for those who received placebo (HR, 0.55; 95% CI, 0.31 to 0.85; P = .009).15”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
plainn = 96 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“Outcomes were worse with first-line erlotinib, followed by an immediate switch to chemotherapy at progression.”
What the sources say
- Not checked yetcites [102] Gridelli C, Maione P, Rossi A. The PARAMOUNT trial: A phase III randomized study of maintenance pemetrexed versus placebo immediately following induction first-line treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small cell lung cancer. Rev Recent Clin Trials. 2013;8:23–28. doi: 10.2174/15748871112079990040. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Cetuximab is not approved by the regulatory agencies in the United States, Canada, or Europe for patients with NSCLC.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In the trial by Gridelli et al,102 which was stopped early and is discussed under Recommendation B1, participants were unselected for EGFR mutation status; 13.8% of the participants in the intervention arm and 14.6% in the control arm had EGFR mutation–positive disease.”
What the sources say
- Not checked yetcites [102] Gridelli C, Maione P, Rossi A. The PARAMOUNT trial: A phase III randomized study of maintenance pemetrexed versus placebo immediately following induction first-line treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small cell lung cancer. Rev Recent Clin Trials. 2013;8:23–28. doi: 10.2174/15748871112079990040. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Patients whose cancers initially respond to crizotinib often experience a relapse of the disease.56”
What the sources say
- Not checked yetcites [56] Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368:2385–2394. doi: 10.1056/NEJMoa1214886. [DOI] [PubMed] [Google Scholar] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A subset analysis of the IPASS study, in which patients with adenocarcinoma of the lung were randomly assigned to receive gefitinib or carboplatin plus paclitaxel, demonstrated no difference in OS in either the EGFR mutation–positive arm or the EGFR mutation–negative arm.”
What the sources say
- Not checked yetcites [30] Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS) J Clin Oncol. 2011;29:2866–2874. doi: 10.1200/JCO.2010.33.4235. [DOI] [PubMed] [Google Scholar] source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“At the subsequently approved dose of 750 mg once daily, the response rate was 59% (95% CI, 47 to 70).”
What the sources say
- Not checked yetcites [42] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–1197. doi: 10.1056/NEJMoa1311107. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 122- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The noncomparative study reported by Kim et al43 included 163 participants who had received first-line crizotinib and 83 who had not.”
What the sources say
- Not checked yetcites [43] Kim DW, Mehra R, Tan DSW. Ceritinib in advanced anaplastic lymphoma kinase (ALK)-rearranged (ALK+) non-small cell lung cancer (NSCLC): Results of the ASCEND-1 trial. J Clin Oncol. 2014;32(suppl 5s):506s. abstr 8003. [Google Scholar] source
plainn = 163- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“PFS in the population of patients who were not pretreated was not estimable at the time of the presentation.”
What the sources say
- Not checked yetcites [43] Kim DW, Mehra R, Tan DSW. Ceritinib in advanced anaplastic lymphoma kinase (ALK)-rearranged (ALK+) non-small cell lung cancer (NSCLC): Results of the ASCEND-1 trial. J Clin Oncol. 2014;32(suppl 5s):506s. abstr 8003. [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“OS for the patients who had EGFR-positive disease was 21.6 months in the gefitinib arm and 21.9 months in the chemotherapy arm (HR, 1.00; 95% CI, 0.76 to 1.33).30”
What the sources say
- Not checked yetcites [30] Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS) J Clin Oncol. 2011;29:2866–2874. doi: 10.1200/JCO.2010.33.4235. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In an interim analysis, 12-month OS was 65% for all participants.42”
What the sources say
- Not checked yetcites [42] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–1197. doi: 10.1056/NEJMoa1311107. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The FDA approved ceritinib on the basis of a phase I single-arm trial.102b”
What the sources say
- Not checked yetcites 102b
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: FDA approval is a sufficient basis for including a therapy in a clinical practice guideline recommendation.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As a result, the reliability of outcome data from these studies may be limited, thereby creating constraints against making recommendations for care in this heterogeneous patient population.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The best available evidence for treating index conditions often comes from clinical trials whose study selection criteria may exclude patients with MCCs to avoid potential interaction effects or confounding of results.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, racial, ethnic, and socioeconomic disparities in health care contribute significantly to health disparities in the United States.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Hospice use of any type and duration is strongly associated with better OS in patients with advanced cancer,119 including those specifically with lung cancer.120”
What the sources say
- Not checked yetcites [119] Connor SR, Pyenson B, Fitch K, et al. Comparing hospice and nonhospice patient survival among patients who die within a three-year window. J Pain Symptom Manage. 2007;33:238–246. doi: 10.1016/j.jpainsymman.2006.10.010. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [120] Saito AM, Landrum MB, Neville BA, et al. Hospice care and survival among elderly patients with lung cancer. J Palliat Med. 2011;14:929–939. doi: 10.1089/jpm.2010.0522. [DOI] [PMC free article] [PubMed] [Google Scholar] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In addition, a cluster RCT published since the provisional clinical opinion, which included participants with NSCLC, showed important improvements in QoL, symptoms, and caregiver distress.106”
What the sources say
- Not checked yetcites [106] Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: A cluster-randomised controlled trial. Lancet. 2014;383:1721–1730. doi: 10.1016/S0140-6736(13)62416-2. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 85
- Probably not a substantial claim. 35
- The quote only partly states this claim. 3
In the paper
“It compared cisplatin plus gemcitabine with cisplatin plus pemetrexed and demonstrated improved OS for patients with adenocarcinoma treated with cisplatin plus pemetrexed (whereas cisplatin plus gemcitabine was superior for patients with SCC).”
What the sources say
- Not checked yetcites Scagliotti et al68
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“OS, PFS, and response rate were not statistically significantly different. The study did meet its primary end point of OS without grade 3 to 4 toxicity with pemetrexed plus carboplatin.70”
What the sources say
- Not checked yetcites [70] Rodrigues-Pereira J, Kim JH, Magallanes M, et al. A randomized phase 3 trial comparing pemetrexed/carboplatin and docetaxel/carboplatin as first-line treatment for advanced, nonsquamous non-small cell lung cancer. J Thorac Oncol. 2011;6:1907–1914. doi: 10.1097/JTO.0b013e318226b5fa. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The trial included participants with NSCC and SCC and compared nab-paclitaxel plus carboplatin with solvent-based paclitaxel plus carboplatin and found an improvement in the primary end point of response rate. There was no statistically significant difference in OS. Some adverse events occurred at a lower rate with the intervention.26”
What the sources say
- Not checked yetcites [26] Socinski MA, Bondarenko I, Karaseva NA, et al. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non–small-cell lung cancer: Final results of a phase III trial. J Clin Oncol. 2012;30:2055–2062. doi: 10.1200/JCO.2011.39.5848. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Carboplatin plus paclitaxel (ie, taxane plus carboplatin control) was used in both arms of a cetuximab trial that found no statistically significant difference in PFS; it lacked the power to determine an OS difference.71”
What the sources say
- Not checked yetcites [71] Lynch TJ, Patel T, Dreisbach L, et al. Cetuximab and first-line taxane/carboplatin chemotherapy in advanced non–small-cell lung cancer: Results of the randomized multicenter phase III trial BMS099. J Clin Oncol. 2010;28:911–917. doi: 10.1200/JCO.2009.21.9618. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Another trial compared two courses of cisplatin plus gemcitabine plus three courses of gemcitabine (arm one) versus five courses of cisplatin plus gemcitabine (arm two); the study did not demonstrate noninferiority in efficacy, and there was a higher rate of adverse events in arm two.39”
What the sources say
- Not checked yetcites [39] Novello S, Bruzzi P, Barone C, et al. Phase III study in stage IV non-small-cell lung cancer patients treated with two courses of cisplatin/gemcitabine followed by a randomization to three additional courses of the same combination or gemcitabine alone. Ann Oncol. 2007;18:903–908. doi: 10.1093/annonc/mdm061. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with severe comorbidity reported poorer HRQoL but not significantly greater deterioration of HRQoL.19”
What the sources say
- Not checked yetcites [19] Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer. 2010;46:2225–2234. doi: 10.1016/j.ejca.2010.04.009. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a study of pemetrexed plus carboplatin versus gemcitabine plus carboplatin, there was no statistically significant difference in efficacy; however, there were fewer hematologic adverse events with pemetrexed plus carboplatin.18”
What the sources say
- Not checked yetcites [18] Grønberg BH, Bremnes RM, Fløtten O, et al. Phase III study by the Norwegian lung cancer study group: Pemetrexed plus carboplatin compared with gemcitabine plus carboplatin as first-line chemotherapy in advanced non–small-cell lung cancer. J Clin Oncol. 2009;27:3217–3224. doi: 10.1200/JCO.2008.20.9114. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were 51 trials in the first-line and maintenance settings, including seven trials for the treatment of patients with epidermal growth factor receptor (EGFR) mutations or increased EGFR expression.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The only study showing positive results in a comparison between one of the listed cisplatin-based combinations and a new agent was for patients with EGFR-positive NSCLC (see Recommendation A4), in which afatinib was more efficacious than cisplatin plus pemetrexed.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with severe comorbidity had survival similar to that of other patients (6.9 v 8.1 months; P = .34) and a similar frequency of neutropenia (48% v 42%; P = .16) but experienced more neutropenic fevers (12% v 5%; P = .012) and deaths resulting from neutropenic infections (3% v 0%; P = .027).”
What the sources say
- Not checked yetcites [19] Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer. 2010;46:2225–2234. doi: 10.1016/j.ejca.2010.04.009. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one trial of four cycles of carboplatin plus paclitaxel versus five cycles of vinorelbine or gemcitabine, OS and PFS were statistically significantly longer with carboplatin plus paclitaxel, and adverse events occurred at a higher frequency53”
What the sources say
- Not checked yetcites [53] Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011;378:1079–1088. doi: 10.1016/S0140-6736(11)60780-0. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a trial of cisplatin plus gemcitabine versus gemcitabine, OS and PFS were statistically significantly longer with the combination therapy.”
What the sources say
- Not checked yetcites [58] Morabito A, Gebbia V, Di Maio M, et al. Randomized phase III trial of gemcitabine and cisplatin vs. gemcitabine alone in patients with advanced non-small cell lung cancer and a performance status of 2: The CAPPA-2 study. Lung Cancer. 2013;81:77–83. doi: 10.1016/j.lungcan.2013.04.008. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One trial compared two nonplatinum regimens (paclitaxel plus gemcitabine v paclitaxel plus vinorelbine); paclitaxel plus vinorelbine did not improve efficacy and increased toxicity.75”
What the sources say
- Not checked yetcites [75] Kosmidis PA, Fountzilas G, Eleftheraki AG, et al. Paclitaxel and gemcitabine versus paclitaxel and vinorelbine in patients with advanced non-small-cell lung cancer: A phase III study of the Hellenic Cooperative Oncology Group (HeCOG) Ann Oncol. 2011;22:827–834. doi: 10.1093/annonc/mdq445. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It compared pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab (arm one) versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab (arm two).37 PFS, but not OS, was improved using bevacizumab plus pemetrexed.”
What the sources say
- Not checked yetcites [37] Patel JD, Socinski MA, Garon EB, et al. PointBreak: A randomized phase III study of pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non–small-cell lung cancer. J Clin Oncol. 2013;31:4349–4357. doi: 10.1200/JCO.2012.47.9626. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Carboplatin plus paclitaxel was administered to the control arm in a trial of carboplatin plus oral S-1, a regimen used in Japan but not in the United States. The results of this trial showed noninferiority in OS with S-1.72”
What the sources say
- Not checked yetcites [72] Okamoto I, Yoshioka H, Morita S, et al. Phase III trial comparing oral S-1 plus carboplatin with paclitaxel plus carboplatin in chemotherapy-naive patients with advanced non–small-cell lung cancer: Results of a West Japan Oncology Group study. J Clin Oncol. 2010;28:5240–5246. doi: 10.1200/JCO.2010.31.0326. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One trial that compared bevacizumab plus erlotinib versus bevacizumab plus placebo resulted in a 1.1-month longer PFS—the primary end point of the study—but there was no increase in OS, and adverse events were more frequent or of higher grade with the intervention.35”
What the sources say
- Not checked yetcites [35] Johnson BE, Kabbinavar F, Fehrenbacher L, et al. ATLAS: Randomized, double-blind, placebo-controlled, phase IIIB trial comparing bevacizumab therapy with or without erlotinib, after completion of chemotherapy, with bevacizumab for first-line treatment of advanced non–small-cell lung cancer. J Clin Oncol. 2013;31:3926–3934. doi: 10.1200/JCO.2012.47.3983. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the present updated systematic review, four RCTs were identified that included bevacizumab33,35,37,76—three in the maintenance setting.”
What the sources say
- Not checked yetcites [33] Barlesi F, Scherpereel A, Rittmeyer A, et al. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non–small-cell lung cancer: AVAPERL (MO22089) J Clin Oncol. 2013;31:3004–3011. doi: 10.1200/JCO.2012.42.3749. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [35] Johnson BE, Kabbinavar F, Fehrenbacher L, et al. ATLAS: Randomized, double-blind, placebo-controlled, phase IIIB trial comparing bevacizumab therapy with or without erlotinib, after completion of chemotherapy, with bevacizumab for first-line treatment of advanced non–small-cell lung cancer. J Clin Oncol. 2013;31:3926–3934. doi: 10.1200/JCO.2012.47.3983. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [37] Patel JD, Socinski MA, Garon EB, et al. PointBreak: A randomized phase III study of pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non–small-cell lung cancer. J Clin Oncol. 2013;31:4349–4357. doi: 10.1200/JCO.2012.47.9626. [DOI] [PMC free article] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The first trial,55 which included 205 participants, compared carboplatin plus pemetrexed with pemetrexed alone. In the results, OS and PFS were statistically significantly longer with the combination.”
What the sources say
- Not checked yetcites [55] Zukin M, Barrios CH, Pereira JR, et al. Randomized phase III trial of single-agent pemetrexed versus carboplatin and pemetrexed in patients with advanced non–small-cell lung cancer and Eastern Cooperative Oncology Group performance status of 2. J Clin Oncol. 2013;31:2849–2853. doi: 10.1200/JCO.2012.48.1911. [DOI] [PubMed] [Google Scholar]
plaindirectn = 205- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Finally, no new trials included the combination of carboplatin plus irinotecan or carboplatin plus vinorelbine.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“One trial with 56 participants compared cisplatin plus gemcitabine with gemcitabine and found that OS and PFS were statistically significantly longer with the combination and QoL was also higher; however, the study was stopped early and had few participants.58”
What the sources say
- Not checked yetcites [58] Morabito A, Gebbia V, Di Maio M, et al. Randomized phase III trial of gemcitabine and cisplatin vs. gemcitabine alone in patients with advanced non-small cell lung cancer and a performance status of 2: The CAPPA-2 study. Lung Cancer. 2013;81:77–83. doi: 10.1016/j.lungcan.2013.04.008. [DOI] [PubMed] [Google Scholar]
plaindirectn = 56- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The updated systematic review included final OS results, which were not statistically significantly different (overall: 18.8 v 17.4 months; EGFR positive: 21.6 v 21.9 months).30”
What the sources say
- Not checked yetcites [30] Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS) J Clin Oncol. 2011;29:2866–2874. doi: 10.1200/JCO.2010.33.4235. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One study that compared pemetrexed and erlotinib did not find significant efficacy differences but did find a higher rate of hematologic adverse effects in the pemetrexed arm (neutropenia: P = .001; thrombocytopenia: P = .013; anemia: P = .001).93”
What the sources say
- Not checked yetcites [93] Karampeazis A, Voutsina A, Souglakos J, et al. Pemetrexed versus erlotinib in pretreated patients with advanced non-small cell lung cancer: A Hellenic Oncology Research Group (HORG) randomized phase 3 study. Cancer. 2013;119:2754–2764. doi: 10.1002/cncr.28132. [DOI] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This benefit was retained with doublet therapy in the subgroup with PS 2 and in those age > 80 years, which each constituted approximately one fourth of the study population.”
What the sources say
- Not checked yetcites [53] Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011;378:1079–1088. doi: 10.1016/S0140-6736(11)60780-0. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one trial,47 PFS, but not OS, was higher with chemotherapy.”
What the sources say
- Not checked yetcites [47] Lee DH, Park K, Kim JH, et al. Randomized phase III trial of gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received platinum-based chemotherapy. Clin Cancer Res. 2010;16:1307–1314. doi: 10.1158/1078-0432.CCR-09-1903. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It compared four cycles of carboplatin plus paclitaxel versus monotherapy; OS favored the doublet for an elderly population. Median OS was superior for doublet chemotherapy versus monotherapy (10.3 v 6.2 months; HR, 0.64; P < .001).”
What the sources say
- Not checked yetcites [53] Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011;378:1079–1088. doi: 10.1016/S0140-6736(11)60780-0. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“PFS was 0.5 months longer.”
What the sources say
- Not checked yetcites [41] Garassino MC, Martelli O, Broggini M, et al. Erlotinib versus docetaxel as second-line treatment of patients with advanced non-small-cell lung cancer and wild-type EGFR tumours (TAILOR): A randomised controlled trial. Lancet Oncol. 2013;14:981–988. doi: 10.1016/S1470-2045(13)70310-3. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“Treatment-related serious adverse events more frequent with chemotherapy, although rash was more common with erlotinib.46”
What the sources say
- Not checked yetcites [46] Ciuleanu T, Stelmakh L, Cicenas S, et al. Efficacy and safety of erlotinib versus chemotherapy in second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis (TITAN): A randomised multicentre, open-label, phase 3 study. Lancet Oncol. 2012;13:300–308. doi: 10.1016/S1470-2045(11)70385-0. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Hematologic adverse events were more frequent with ramucirumab plus docetaxel, as were other adverse events, such as diarrhea, dyspnea, and fatigue.57”
What the sources say
- Not checked yetcites [57] Garon EB, Ciuleanu TE, Arrieta O. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): A multicentre, double-blind, randomised phase 3 trial. Lancet. 2014;384:665–673. doi: 10.1016/S0140-6736(14)60845-X. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Serious adverse events were more frequent with chemotherapy, although treatment-related deaths were more frequent among patients treated with gefitinib.47”
What the sources say
- Not checked yetcites [47] Lee DH, Park K, Kim JH, et al. Randomized phase III trial of gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received platinum-based chemotherapy. Clin Cancer Res. 2010;16:1307–1314. doi: 10.1158/1078-0432.CCR-09-1903. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A similar protocol amendment occurred in the TITAN trial, in which 35% to 38% of participants had SCC; however, participants were not stratified according to histology, and analyses by histology were not preplanned.46”
What the sources say
- Not checked yetcites [46] Ciuleanu T, Stelmakh L, Cicenas S, et al. Efficacy and safety of erlotinib versus chemotherapy in second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis (TITAN): A randomised multicentre, open-label, phase 3 study. Lancet Oncol. 2012;13:300–308. doi: 10.1016/S1470-2045(11)70385-0. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No significant differences in OS were found for participants with SCC, but TTP was longer with erlotinib (both findings were identified in exploratory analyses by histology; OS: P = .006).93”
What the sources say
- Not checked yetcites [93] Karampeazis A, Voutsina A, Souglakos J, et al. Pemetrexed versus erlotinib in pretreated patients with advanced non-small cell lung cancer: A Hellenic Oncology Research Group (HORG) randomized phase 3 study. Cancer. 2013;119:2754–2764. doi: 10.1002/cncr.28132. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One trial tested a new vascular endothelial growth factor inhibitor for NSCLC, ramucirumab (plus docetaxel); the intervention arm experienced longer PFS (by 1.5 months) and OS (by 1.4 months), both statistically significant.”
What the sources say
- Not checked yetcites [57] Garon EB, Ciuleanu TE, Arrieta O. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): A multicentre, double-blind, randomised phase 3 trial. Lancet. 2014;384:665–673. doi: 10.1016/S0140-6736(14)60845-X. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The objective response rate was 72% (95% CI, 58 to 84), and there were three complete responses and 33 partial responses.”
What the sources say
- Not checked yetcites [78] Shaw AT, Ou SH, Bang YJ, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014;371:1963–1971. doi: 10.1056/NEJMoa1406766. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the last trial,49 PFS, but not OS, was longer with gefitinib versus pemetrexed, and serious adverse events more frequent with gefitinib.”
What the sources say
- Not checked yetcites [49] Sun JM, Lee KH, Kim SW, et al. Gefitinib versus pemetrexed as second-line treatment in patients with nonsmall cell lung cancer previously treated with platinum-based chemotherapy (KCSG-LU08-01): An open-label, phase 3 trial. Cancer. 2012;118:6234–6242. doi: 10.1002/cncr.27630. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There was no efficacy advantage in another trial23; overall adverse events more frequent with chemotherapy.23”
What the sources say
- Not checked yetcites [23] Maruyama R, Nishiwaki Y, Tamura T, et al. Phase III study, V-15-32, of gefitinib versus docetaxel in previously treated Japanese patients with non–small-cell lung cancer. J Clin Oncol. 2008;26:4244–4252. doi: 10.1200/JCO.2007.15.0185. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although PFS was statistically significantly longer at 0.7 months with the combination, the OS improvement (ie, 2.57 months longer) did not reach statistical significance.”
What the sources say
- Not checked yetcites [67] Pallis AG, Agelaki S, Agelidou A, et al. A randomized phase III study of the docetaxel/carboplatin combination versus docetaxel single-agent as second line treatment for patients with advanced/metastatic non-small cell lung cancer. BMC Cancer. 2010;10:633. doi: 10.1186/1471-2407-10-633. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Expected chemotherapy adverse effects were more common in the docetaxel arm, and rash (but not diarrhea) occurred more frequently in the erlotinib arm.41”
What the sources say
- Not checked yetcites [41] Garassino MC, Martelli O, Broggini M, et al. Erlotinib versus docetaxel as second-line treatment of patients with advanced non-small-cell lung cancer and wild-type EGFR tumours (TAILOR): A randomised controlled trial. Lancet Oncol. 2013;14:981–988. doi: 10.1016/S1470-2045(13)70310-3. [DOI] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Some hematologic adverse events were more frequent with first-line chemotherapy; as expected, rash occurred more often with first-line erlotinib.94”
What the sources say
- Not checked yetcites [94] Gridelli C, Ciardiello F, Gallo C, et al. First-line erlotinib followed by second-line cisplatin–gemcitabine chemotherapy in advanced non–small-cell lung cancer: The TORCH randomized trial. J Clin Oncol. 2012;30:3002–3011. doi: 10.1200/JCO.2011.41.2056. [DOI] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Efficacy outcomes were lower with first-line erlotinib, but the differences were not statistically significant.”
What the sources say
- Not checked yetcites [94] Gridelli C, Ciardiello F, Gallo C, et al. First-line erlotinib followed by second-line cisplatin–gemcitabine chemotherapy in advanced non–small-cell lung cancer: The TORCH randomized trial. J Clin Oncol. 2012;30:3002–3011. doi: 10.1200/JCO.2011.41.2056. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Other studies found in the updated systematic review did not result in evidence supporting other changes in the recommendation. These studies investigated thalidomide,38 bevacizumab plus erlotinib,35 gemcitabine,39 bevacizumab plus pemetrexed,33,37 bevacizumab alone,37 and gefitinib.34,36”
What the sources say
- Not checked yetcites [38] Lee SM, Rudd R, Woll PJ, et al. Randomized double-blind placebo-controlled trial of thalidomide in combination with gemcitabine and Carboplatin in advanced non–small-cell lung cancer. J Clin Oncol. 2009;27:5248–5254. doi: 10.1200/JCO.2009.21.9733. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [35] Johnson BE, Kabbinavar F, Fehrenbacher L, et al. ATLAS: Randomized, double-blind, placebo-controlled, phase IIIB trial comparing bevacizumab therapy with or without erlotinib, after completion of chemotherapy, with bevacizumab for first-line treatment of advanced non–small-cell lung cancer. J Clin Oncol. 2013;31:3926–3934. doi: 10.1200/JCO.2012.47.3983. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [39] Novello S, Bruzzi P, Barone C, et al. Phase III study in stage IV non-small-cell lung cancer patients treated with two courses of cisplatin/gemcitabine followed by a randomization to three additional courses of the same combination or gemcitabine alone. Ann Oncol. 2007;18:903–908. doi: 10.1093/annonc/mdm061. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the largest trial of concurrent palliative care plus oncology care versus oncology care alone, patients treated by their oncologists alone had less prognostic awareness that they could not be cured, received more intravenous chemotherapy in the last 60 days of life, used hospice less often and for shorter periods, and died 2.7 months sooner than those who used palliative care.111”
What the sources say
- Not checked yetcites [111] Roeland E, Loprinzi C, Moynihan TJ, et al. In chemotherapy for lung cancer, sometimes less is more. J Natl Compr Canc Netw. 2013;11:232–235. doi: 10.6004/jnccn.2013.0034. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies were found to recommend a change from the previous recommendation.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The evidence does not support the selection of a specific second-line chemotherapy drug or combination based on age alone.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“However, final results of OS have not been reported for most studies; therefore, the outcomes of those patients who crossed over to chemotherapy have not been yet analyzed.11,13,20,29,94”
What the sources say
- Not checked yetcites [11] Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31:3327–3334. doi: 10.1200/JCO.2012.44.2806. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [13] Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12:735–742. doi: 10.1016/S1470-2045(11)70184-X. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Neither study reported the survival of patients who did or did not experience an initial response to gefitinib.20,21”
What the sources say
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [21] Inoue A, Kobayashi K, Maemondo M, et al. Updated overall survival results from a randomized phase III trial comparing gefitinib with carboplatin-paclitaxel for chemo-naïve non-small cell lung cancer with sensitive EGFR gene mutations (NEJ002) Ann Oncol. 2013;24:54–59. doi: 10.1093/annonc/mds214. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These studies have also reported better QoL, less depression and anxiety, and less caregiver distress with palliative care.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are not enough data on patients with large-cell neuroendocrine carcinoma or enough mature data on ROS1 and crizotinib or on second-line treatment for patients who received first-line treatment with an EGFR TKI and experienced disease progression or for those who received an EGFR TKI and had an initial response.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“An environmental scan of related literature published since 2009 found that patients with NSCLC continue to grapple with complex medical, psychological, and social issues.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are not yet sufficient objective tools available to clinicians to determine which patients would benefit from and tolerate combined therapy in comparison with single-agent chemotherapy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“In addition, there are not enough mature data on adding pemetrexed to bevacizumab plus carboplatin; there has been only one phase III trial.153”
What the sources say
- Not checked yetcites [153] Patel JD, Hensing TA, Rademaker A, et al. Phase II study of pemetrexed and carboplatin plus bevacizumab with maintenance pemetrexed and bevacizumab as first-line therapy for nonsquamous non–small-cell lung cancer. J Clin Oncol. 2009;27:3284–3289. doi: 10.1200/JCO.2008.20.8181. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some factors varied between studies, lowering the comparability of the results.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This update includes 73 phase III randomized controlled trials (RCTs) on systemic therapy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Articles were excluded from the systematic review if they were: (1) meeting abstracts not subsequently published in peer-reviewed journals (with one exception made for 2014 ASCO abstract presenting only phase III data on agent recently approved by US Food and Drug Administration [FDA]6); (2) editorials, commentaries, letters, news articles, case reports, or narrative reviews; or (3) published in a”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“however, the trial had low accrual and was stopped early58”
What the sources say
- Not checked yetcites [58] Morabito A, Gebbia V, Di Maio M, et al. Randomized phase III trial of gemcitabine and cisplatin vs. gemcitabine alone in patients with advanced non-small cell lung cancer and a performance status of 2: The CAPPA-2 study. Lung Cancer. 2013;81:77–83. doi: 10.1016/j.lungcan.2013.04.008. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In accordance with these procedures, the majority of the members of the Update Committee did not disclose any such relationships.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The guideline recommendations were crafted, in part, using the Guidelines Into Decision Support (GLIDES) methodology and accompanying BRIDGE-Wiz software (http://gem.med.yale.edu/BRIDGE-Wiz).”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Study quality was formally assessed for the RCTs directly relevant to current recommendations”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The Update Committee was assembled in accordance with the ASCO Conflicts of Interest Management Procedures for Clinical Practice Guidelines (summarized at http://www.asco.org/rwc).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Because there is no cure for patients with stage IV NSCLC, early concomitant palliative care assistance has improved the survival and well being of patients and is therefore recommended”
What the sources say
- Not checked yetcites [5] Smith TJ, Temin S, Alesi ER, et al. American Society of Clinical Oncology provisional clinical opinion: The integration of palliative care into standard oncology care. J Clin Oncol. 2012;30:880–887. doi: 10.1200/JCO.2011.38.5161. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In some selected cases where evidence was lacking but there was a high level of agreement among the Update Committee, informal consensus was used (as noted with Recommendations).”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Articles were selected for inclusion in the systematic review of the evidence based on the following criteria: (1) population of patients with stage IV NSCLC (many trials also included patients with stage IIIB NSCLC), and (2) fully published presentations of English-language reports of phase III RCTs.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The PubMed database was searched for evidence reporting on outcomes of interest, published from January 2007 to February 2014 for non–switch maintenance questions and from June 2009 to February 2014 for switch maintenance questions.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Design aspects related to the individual study quality were assessed by one reviewer, with factors such as blinding, allocation concealment, placebo control, intention to treat, and funding sources generally indicating an intermediate to high potential risk of bias for most of the identified evidence.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“the study was closed prematurely.52”
What the sources say
- Not checked yetcites [52] Georgoulias V, Androulakis N, Kotsakis A, et al. Docetaxel versus docetaxel plus gemcitabine as front-line treatment of patients with advanced non-small cell lung cancer: A randomized, multicenter phase III trial. Lung Cancer. 2008;59:57–63. doi: 10.1016/j.lungcan.2007.07.021. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These agents offer equal or superior efficacy and toxicity profiles compared with standard cytotoxic chemotherapy.”
plainn = 343- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients with negative or unknown EGFR/ALK status with SCC histology and PS 2 may benefit from treatment with either combination or single-agent chemotherapy.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The data regarding adding bevacizumab to carboplatin plus pemetrexed are not yet mature; therefore, there are insufficient data on which to base a recommendation.”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, these uncommon tumors are important to identify, because they are treatable with FDA-approved oral agents (crizotinib and ceritinib).”
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Combination treatment can improve outcomes for patients with negative or unknown EGFR/ALK status with NSCC histology and PS 0 to 2 who may also receive treatment with either combination or single-agent chemotherapy or palliative care concurrently or alone.”
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“however, the study was stopped early and had few participants.58”
What the sources say
- Not checked yetcites [58] Morabito A, Gebbia V, Di Maio M, et al. Randomized phase III trial of gemcitabine and cisplatin vs. gemcitabine alone in patients with advanced non-small cell lung cancer and a performance status of 2: The CAPPA-2 study. Lung Cancer. 2013;81:77–83. doi: 10.1016/j.lungcan.2013.04.008. [DOI] [PubMed] [Google Scholar]
plainn = 56- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“The individual patient data meta-analysis by Di Maio et al95 of single versus doublet therapy in the second-line setting found that “doublet chemotherapy as second-line treatment of advanced NSCLC significantly increases response rate and progression-free survival, but is more toxic and does not improve overall survival compared with single-agent.”95(p1836)”
What the sources say
- Not checked yetcites Di Maio et al95
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Single-agent therapy is appropriate for patients with SCC in the second-line setting.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
In the paper
“Median time to response was 3.3 months; median duration of response had not been reached at the time of publication.”
What the sources say
- Not checked yetcites [98] Rizvi NA, Mazières J, Planchard D, et al. Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small-cell lung cancer (CheckMate 063): A phase 2, single-arm trial. Lancet Oncol. 2015;16:257–265. doi: 10.1016/S1470-2045(15)70054-9. [DOI] [PMC free article] [PubMed] [Google Scholar] source
plainn = 117- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is no definite evidence that combination therapy is superior, but it may be more toxic.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nonetheless, there is no absolute preference for chemotherapy versus targeted therapy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Adverse effects included dyspnea, fatigue, pneumonitis, diarrhea, musculoskeletal pain, and severe immune-mediated adverse effects98,99; 59% of patients experienced serious adverse events.100”
What the sources say
- Not checked yetcites [98] Rizvi NA, Mazières J, Planchard D, et al. Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small-cell lung cancer (CheckMate 063): A phase 2, single-arm trial. Lancet Oncol. 2015;16:257–265. doi: 10.1016/S1470-2045(15)70054-9. [DOI] [PMC free article] [PubMed] [Google Scholar] source
- Not checked yetcites [99]
- Not checked yetcites [100]
plainn = 117- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These patients are unlikely to harbor EGFR/ALK gene mutations and may benefit from chemotherapy rather than targeted therapy with an EGFR TKI.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“In the IPASS trial comparing gefitinib with carboplatin plus paclitaxel, in the subgroup of patients with unknown EGFR mutation status, there were statistically significantly longer PFS and higher response rates.61”
What the sources say
- Not checked yetcites [61] Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361:947–957. doi: 10.1056/NEJMoa0810699. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients with nonsquamous histology who have not received pemetrexed therapy in the first-line setting may benefit from receiving pemetrexed in the second-line setting.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the absence of EGFR/ALK mutations, chemotherapy may be a preferable approach.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“In a prespecified analysis, participants with a complete or partial response to a first-line EGFR TKI whose tumors also had known EGFR mutation test results (58 [88%] of 66), the HR for PFS was significant (0.23), but the HR for OS was not (0.90) in the afatinib arm.”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, another phase III study of gefitinib versus carboplatin plus paclitaxel in patients with EGFR-sensitizing mutations also found an improvement in PFS but not OS, again presumably secondarily to crossover to chemotherapy in the gefitinib arm.”
What the sources say
- Not checked yetcites [20] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–2388. doi: 10.1056/NEJMoa0909530. [DOI] [PubMed] [Google Scholar] source
- Not checked yetcites [21] Inoue A, Kobayashi K, Maemondo M, et al. Updated overall survival results from a randomized phase III trial comparing gefitinib with carboplatin-paclitaxel for chemo-naïve non-small cell lung cancer with sensitive EGFR gene mutations (NEJ002) Ann Oncol. 2013;24:54–59. doi: 10.1093/annonc/mds214. [DOI] [PubMed] [Google Scholar] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Toxicities (and durability) seem similar to those of crizotinib, including a low risk for serious pneumonitis; long-term outcomes are still under study.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the afatinib trial, response rates in both arms were lower than in studies with chemotherapy; however, given the longer PFS, afatinib after gefitinib or erlotinib in patients with EGFR-sensitizing mutations who experienced an initial response may be an option.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The FDA-approved label for patients who receive ceritinib who have previously received crizotinib states that “continued approval for this indication may be contingent on verification and description of clinical benefit in confirmatory trials.””
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As stated in Recommendation A8, age alone is not a contraindication to chemotherapy for NSCLC.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“In a report by Shaw et al,42 80 of 122 of previously treated patients had received crizotinib, and the response rate with ceritinib was 56% (95% CI, 45 to 67).”
What the sources say
- Not checked yetcites [42] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–1197. doi: 10.1056/NEJMoa1311107. [DOI] [PMC free article] [PubMed] [Google Scholar]
plainn = 122- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In 2012, ASCO reviewed the evidence from an RCT showing an increase in median OS for patients receiving palliative care services concurrently with disease-modifying therapy. The participants in that study had stage IV NSCLC.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Grade 3 to 4 adverse effects in all patients included increases in ALT, AST, and glucose, as well as diarrhea.”
What the sources say
- Not checked yetcites [43] Kim DW, Mehra R, Tan DSW. Ceritinib in advanced anaplastic lymphoma kinase (ALK)-rearranged (ALK+) non-small cell lung cancer (NSCLC): Results of the ASCEND-1 trial. J Clin Oncol. 2014;32(suppl 5s):506s. abstr 8003. [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The study found no improvement in the primary end point of OS between patients randomly assigned to afatinib and those randomly assigned to placebo, although PFS was longer in the afatinib group (3.3 v 1.1 months; HR, 0.38; 95% CI, 0.31 to 0.48; P < .001).”
What the sources say
- Not checked yetcites [15] Miller VA, Hirsh V, Cadranel J, et al. Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): A phase 2b/3 randomised trial. Lancet Oncol. 2012;13:528–538. doi: 10.1016/S1470-2045(12)70087-6. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Grade 3 to 4 adverse effects included increased ALT and increased AST levels, diarrhea, and increased lipase levels. There were four cases of interstitial lung disease.”
What the sources say
- Not checked yetcites [42] Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–1197. doi: 10.1056/NEJMoa1311107. [DOI] [PMC free article] [PubMed] [Google Scholar]
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“PFS was 6.9 months (95% CI, 5.39 to 8.41) for those pretreated with crizotinib, and the overall response rate was 54.6 (95% CI, 46.6 to 62.4).”
What the sources say
- Not checked yetcites [43] Kim DW, Mehra R, Tan DSW. Ceritinib in advanced anaplastic lymphoma kinase (ALK)-rearranged (ALK+) non-small cell lung cancer (NSCLC): Results of the ASCEND-1 trial. J Clin Oncol. 2014;32(suppl 5s):506s. abstr 8003. [Google Scholar]
plainn = 163- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The BMS099 trial of cetuximab in addition to taxane plus carboplatin versus taxane plus carboplatin resulted in a shorter PFS with cetuximab and some adverse effects.71”
What the sources say
- Not checked yetcites [71] Lynch TJ, Patel T, Dreisbach L, et al. Cetuximab and first-line taxane/carboplatin chemotherapy in advanced non–small-cell lung cancer: Results of the randomized multicenter phase III trial BMS099. J Clin Oncol. 2010;28:911–917. doi: 10.1200/JCO.2009.21.9618. [DOI] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This confirmed the evidence from multiple randomized trials that included patients with cancer who showed an improvement in symptoms, including less anxiety and depression, higher satisfaction, less aggressive end-of-life care, and less caregiver distress.108”
What the sources say
- Not checked yetcites [108] Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–742. doi: 10.1056/NEJMoa1000678. [DOI] [PubMed] [Google Scholar]
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
““In medical consultations, patients experience a double-need: to know and understand and to feel known and understood.”121(p3274),127”
What the sources say
- Not checked yetcites 121(p3274)
- Not checked yetcites [127] McGuire L. Ourselves and patients who are dying. Pharos. 1990;53:6–8. [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Socioeconomic status is likely an independent prognostic factor for lung cancer survival.134”
What the sources say
- Not checked yetcites [134] Erhunmwunsee L, Joshi MB, Conlon DH, et al. Neighborhood-level socioeconomic determinants impact outcomes in nonsmall cell lung cancer patients in the southeastern United States. Cancer. 2012;118:5117–5123. doi: 10.1002/cncr.26185. [DOI] [PubMed] [Google Scholar]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Black men continue to have higher incidence rates of lung cancer than white non-Hispanic men.141”
What the sources say
- Not checked yetcites [141] Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975-2011. http://seer.cancer.gov/csr/1975_2011/
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Socioeconomic factors, insurance coverage, and residential segregation also play a role in lung cancer disparities.128,136–138”
What the sources say
- Not checked yetcites [128] Hayanga AJ, Zeliadt SB, Backhus LM. Residential segregation and lung cancer mortality in the United States. JAMA Surg. 2013;148:37–42. doi: 10.1001/jamasurgery.2013.408. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [136] Johnson AM, Hines RB, Johnson JA, 3rd, et al. Treatment and survival disparities in lung cancer: The effect of social environment and place of residence. Lung Cancer. 2014;83:401–407. doi: 10.1016/j.lungcan.2014.01.008. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [137] Slatore CG, Au DH, Gould MK. An official American Thoracic Society systematic review: Insurance status and disparities in lung cancer practices and outcomes. Am J Respir Crit Care Med. 2010;182:1195–1205. doi: 10.1164/rccm.2009-038ST. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [138] Rasco DW, Yan J, Xie Y, et al. Looking beyond Surveillance, Epidemiology, and End Results: Patterns of chemotherapy administration for advanced non-small cell lung cancer in a contemporary, diverse population. J Thorac Oncol. 2010;5:1529–1535. doi: 10.1097/JTO.0b013e3181e9a00f. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Race is associated with lack of any treatment, lack of timely treatment, and lack of appropriate treatment.129,132,142”
What the sources say
- Not checked yetcites [129] Bryant AS, Cerfolio RJ. Impact of race on outcomes of patients with non-small cell lung cancer. J Thorac Oncol. 2008;3:711–715. doi: 10.1097/JTO.0b013e31817c60c7. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [132] Hardy D, Liu CC, Xia R, et al. Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. Cancer. 2009;115:2199–2211. doi: 10.1002/cncr.24248. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [142] Lin JJ, Mhango G, Wall MM, et al. Cultural factors associated with racial disparities in lung cancer care. Ann Am Thorac Soc. 2014;11:489–495. doi: 10.1513/AnnalsATS.201402-055OC. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Each of those listed here is reported with a frequency > 50% in patients age ≥ 65 years, with the prevalence of hypertension, hyperlipidemia, and ischemic heart disease being significantly greater in the older age group.”
What the sources say
- Not checked yetcites [148]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Because of a misunderstanding about prognosis, one third of patients (46 of 145) reported that their cancer was curable at baseline, and a majority of patients (86 of 124) endorsed getting rid of all of the cancer as a goal of therapy.125”
What the sources say
- Not checked yetcites [125] Temel JS, Greer JA, Admane S, et al. Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non–small-cell lung cancer: Results of a randomized study of early palliative care. J Clin Oncol. 2011;29:2319–2326. doi: 10.1200/JCO.2010.32.4459. [DOI] [PubMed] [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, as stated in the 2009 guideline,113 equal access to care can provide similar outcomes.”
What the sources say
- Not checked yetcites [113]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Elderly and female patients also receive disparate treatment.132”
What the sources say
- Not checked yetcites [132] Hardy D, Liu CC, Xia R, et al. Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. Cancer. 2009;115:2199–2211. doi: 10.1002/cncr.24248. [DOI] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with NSCLC often have MCCs; the five most commonly encountered chronic conditions in patients with lung cancer irrespective of age include hypertension, chronic obstructive pulmonary disease, hyperlipidemia, ischemic heart disease, and anemia148”
What the sources say
- Not checked yetcites [148]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There are various validated tools to study comorbidity, particularly in the geriatric literature; these include the Charlson comorbidity index, the Cumulative Illness Rating Scale, the Older Americans Resources and Services (OARS) Multidimensional Functional Assessment Questionnaire, and the Adult Comorbidity Evaluation–27 Index (latter index has been validated irrespective of age).149–152”
What the sources say
- Not checked yetcites [149] Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40:373–383. doi: 10.1016/0021-9681(87)90171-8. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [150] Linn BS, Linn MW, Gurel L. Cumulative illness rating scale. J Am Geriatr Soc. 1968;16:622–626. doi: 10.1111/j.1532-5415.1968.tb02103.x. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [151] Fillenbaum GG, Smyer MA. The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. J Gerontol. 1981;36:428–434. doi: 10.1093/geronj/36.4.428. [DOI] [PubMed] [Google Scholar]
- Not checked yetcites [152] Piccirillo JF, Costas I, Claybour P. The measurement of comorbidity by cancer registries. J Registry Manage. 2003;30:8–14. [Google Scholar]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A stigma is connected with lung cancer because of the association with smoking; this stigma increases depression and decreases QoL.124”
What the sources say
- Not checked yetcites [124] Brown Johnson CG, Brodsky JL, Cataldo JK. Lung cancer stigma, anxiety, depression, and quality of life. J Psychosoc Oncol. 2014;32:59–73. doi: 10.1080/07347332.2013.855963. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with cancer who are members of racial or ethnic minorities may disproportionately experience comorbidities, experience more substantial obstacles to receiving care, be more likely lack insurance, and face a greater risk of receiving poor-quality care than other Americans.140,141,146,147”
What the sources say
- Not checked yetcites [140] American Cancer Society. Cancer Facts & Figures for African Americans 2013-2014. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036921.pdf. source
- Not checked yetcites [141] Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975-2011. http://seer.cancer.gov/csr/1975_2011/
- Not checked yetcites [146] Mead H, Cartwright-Smith L, Jones K, et al. Health Care: A Chartbook. New York, NY: Commonwealth Fund; 2008. Racial and Ethnic Disparities in U.S. [Google Scholar] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Patients with NSCLC often have MCCs; the five most commonly encountered chronic conditions in patients with lung cancer irrespective of age include hypertension, chronic obstructive pulmonary disease, hyperlipidemia, ischemic heart disease, and anemia148”
What the sources say
- Not checked yetcites [148]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Death rates in lung cancer are higher for black men than white men,141 as well as for American Indians and Alaska natives.143”
What the sources say
- Not checked yetcites [141] Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975-2011. http://seer.cancer.gov/csr/1975_2011/
- Not checked yetcites [143] Smith CB, Bonomi M, Packer S, et al. Disparities in lung cancer stage, treatment and survival among American Indians and Alaskan Natives. Lung Cancer. 2011;72:160–164. doi: 10.1016/j.lungcan.2010.08.015. [DOI] [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“For example, in the study of early palliative care for patients with NSCLC discussed in the ASCO provisional clinical opinion, 14% of 151 patients had major depressive syndrome, which significantly predicted worse survival.123”
What the sources say
- Not checked yetcites [123] Pirl WF, Greer JA, Traeger L, et al. Depression and survival in metastatic non-small-cell lung cancer: Effects of early palliative care. J Clin Oncol. 2012;30:1310–1315. doi: 10.1200/JCO.2011.38.3166. [DOI] [PMC free article] [PubMed] [Google Scholar]
plaincorrelationaln = 151- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
110 of 110
The paper relies on this without support.
There is no cure for patients with stage IV NSCLC.
“There is no cure for patients with stage IV NSCLC.”
“There is no cure for patients with stage IV NSCLC.”
The paper relies on this without support.
Understanding of the histologic and molecular subtypes of NSCLC has increased since the 2009 guideline.
“Since the 2009 guideline, the understanding of histologic and molecular subtypes of NSCLC has increased, and as a result, the clinical questions have been reformulated for presentation in terms of histology and molecular subtype.”
The paper relies on this without support.
There are no FDA-approved nonplatinum regimens.
“There are no FDA-approved nonplatinum regimens.”
The paper relies on this without support.
Platinum-based combinations are generally considered to be more effective than non-platinum-based doublets.
“Platinum-based combinations are generally considered to be more effective than non–platinum-based doublets.”
The paper relies on this without support.
Toxicity concerns, particularly major bleeding complications, are relative contraindications to the use of bevacizumab in patients with SCC.
“Toxicity concerns, particularly major bleeding complications, are relative contraindications to the use of bevacizumab in patients with SCC.”
The paper relies on this without support.
There are not yet sufficient objective tools available to clinicians to determine which patients would benefit and tolerate combined therapy in comparison with single-agent chemotherapy.
“There are not yet sufficient objective tools available to clinicians to determine which patients would benefit and tolerate combined therapy in comparison with single-agent chemotherapy.”
The paper relies on this without support.
Large-cell neuroendocrine carcinoma is clinically similar to NSCC.
“As a result of the clinical similarity of large-cell neuroendocrine carcinoma to NSCC, the Update Committee believes a platinum plus etoposide combination may provide optimal efficacy to patients whose tumors have this histology.90”
The paper relies on this without support.
Both PS 2 and elderly populations are heterogeneous, and diminished PS can be a consequence of cancer-related symptoms or MCC.
“Because both PS 2 and elderly populations are heterogeneous, and diminished PS can be a consequence of cancer-related symptoms or MCC, chemotherapy decisions in these subgroups must be individualized, with patient and caregiver input, to optimize outcomes fully with regard to efficacy and treatment-related toxicities.”
The authors state this as an assumption.
For recommendations B3.a and B3.b, clinical experience, training, and judgment are sufficient to formulate recommendations when no data meet inclusion criteria.
“Given that there were no data meeting the inclusion criteria to inform this question, the Update Committee relied on clinical experience, training, and judgment to formulate this recommendation.”
The paper relies on this without support.
FDA approval is a sufficient basis for including a therapy in a clinical practice guideline recommendation.
“Support for including ceritinib in this recommendation is based on FDA approval.”
The paper relies on this without support.
Patients with unknown EGFR/ALK status and clinical demographics (young, female, Asian, nonsmoking) are more likely to have gene mutations and benefit from targeted drugs.
“Patients with unknown EGFR/ALK status who have clinical demographics seen commonly in patients with gene mutations (young, female, Asian, and nonsmoking) may be better served with targeted drugs such as erlotinib or gefitinib.”
The paper relies on this without support.
Many other patients may lack access to care because of geographic location and distance from appropriate treatment facilities.
“Many other patients may lack access to care because of geographic location and distance from appropriate treatment facilities.”
The paper relies on this without support.
Almost one third of older patients have diabetes, heart failure, and chronic kidney disease.
“In addition, almost one third of older patients have diabetes, heart failure, and chronic kidney disease, which have significant repercussions on treatment planning, administration, and tolerance.”
The paper relies on this without support.
MCCs are most relevant for treatment of older adults and those with PS ≥ 2.
“MCCs are most relevant for treatment of older adults and those with PS ≥ 2.”
The paper relies on this without support.
MCCs are associated with greater risk of hematologic toxicity and infectious complications in patients with advanced NSCLC treated with platinum-based chemotherapy.
“MCCs are associated with greater risk of hematologic toxicity and infectious complications in patients with advanced NSCLC treated with platinum-based chemotherapy.”
The paper relies on this without support.
MCCs are also associated with early treatment discontinuation.
“MCCs are also associated with early treatment discontinuation.”
The paper relies on this without support.
The best available evidence for treating index conditions often comes from clinical trials whose study selection criteria may exclude patients with MCCs to avoid potential interaction effects or confounding of results.
“In addition, the best available evidence for treating index conditions often comes from clinical trials, the study selection criteria of which may exclude these patients to avoid potential interaction effects or confounding of results associated with MCCs.”
The paper relies on this without support.
Barriers to implementation include the need to increase awareness of the guideline recommendations among front-line practitioners, survivors of cancer, and caregivers and the need to provide adequate services in the face of limited resources.
“Barriers to implementation include the need to increase awareness of the guideline recommendations among front-line practitioners, survivors of cancer, and caregivers and the need to provide adequate services in the face of limited resources.”
18 of 18
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Among patients with advanced non–small-cell lung cancer with a mutant epidermal growth factor receptor (EGFR), EGFR tyrosine kinase inhibitors (TKIs) are the standard first-line therapy.1–4”
From Osimertinib or Platinum–Pemetrexed in EGFR T790M–Positive Lung Cancer (2017) · cites this paper as [1]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ RESULTS
“Two trials reported significant differences for OS or median survival.41,57”
§ RESULTS
“HR, 0.78 (95% CI, 0.51 to 1.05; P = .10)”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ RESULTS
“Four cycles carboplatin and paclitaxel 225 21 (9.4) — 28 (12.5) 6 (2.6) — 2 (0.9)”
§ RESULTS
“Carboplatin plus taxol 225 21 (9.4) — 108 (48.4) 21 (9.4) — 15 (6.7)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ RESULTS
“one phase III trial (PROFILE 1014; ClinicalTrials.gov identifier NCT01154140)54 comparing crizotinib with standard first-line chemotherapy (either platinum drug plus pemetrexed) for patients with known ALK rearrangements was presented and published (after data cutoff for this guideline).”
§ RESULTS
“There has not yet been a published peer-reviewed report of phase III results.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Pemetrexed, carboplatin, and bevacizumab followed by pemetrexed plus bevacizumab 442 64 (14.5) 6 (2.1)”
Reported 2.1 · recomputed 1.357466
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Placebo plus docetaxel 618 35 (6.0) 13 (2.0) 246 (39.0) 62 (10.0) 77 (12.0) 4 (1.0) 19 (3.0) 27 (1.0)”
Reported 1 · recomputed 4.368932
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Five cycles vinorelbine or gemcitabine 223 10 (4.4) — 108 (48.4) 21 (9.4) — 15 (6.7) 2 (2.9)”
Reported 2.9 · recomputed 0.896861
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Maintenance bevacizumab 7.5 mg/kg 120 0 (0.0) 3 (2.5) 0 (0.0) 0 (0.0) — 1 (1.8)”
Reported 1.8 · recomputed 0.833333
7 of 7
Citations
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742
PD-1 and PD-L1 Immune Checkpoint Blockade to Treat Breast Cancer
Hartkopf, A. D., Taran, F., Wallwiener, M., Walter, C. B., Krämer, B., Grischke, E., & Brucker, S. Y. (2016) · Breast Care · doi:10.1159/000453569 · Cited by 30,989
Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review
Wanchoo, R., Karam, S., Uppal, N. N., Barta, V. S., Deray, G., Devoe, C., Launay‐Vacher, V., Jhaveri, K. D., & on behalf of Cancer and Kidney International Network Workgroup on Immune Checkpoint Inhibitors (2017) · American Journal of Nephrology · doi:10.1159/000455014 · Cited by 15,320
Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer
Reck, M., Rodríguez-Abreu, D., Robinson, A. G., Hui, R., Csőszi, T., Fülöp, A., Gottfried, M., Peled, N., Tafreshi, A., Cuffe, S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1606774 · Cited by 10,089
Self-citationNivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer
Borghaei, H., Paz-Ares, L., Horn, L., Spigel, D. R., Steins, M., Ready, N. E., Chow, L. Q., Vokes, E. E., Felip, E., Holgado, E., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1507643 · Cited by 9,335
Self-citationNivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung Cancer
Brahmer, J., Reckamp, K. L., Baas, P., Crinò, L., Eberhardt, W. E. E., Poddubskaya, E., Antonia, S., Pluzanski, A., Vokes, E. E., Holgado, E., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504627 · Cited by 8,447
Self-citationGefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma
Mok, T. S., Wu, Y.-L., Thongprasert, S., Yang, C.-H., Chu, D.-T., Saijo, N., Sunpaweravong, P., Han, B., Margono, B., Ichinose, Y., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0810699 · Cited by 8,261
Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., Dahlin, C. M., Blinderman, C. D., Jacobsen, J., Pirl, W. F., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1000678 · Cited by 7,482
Herbst, R. S., Baas, P., Kim, D.-W., Felip, E., Pérez-Gracia, J. L., Han, J.-Y., Molina, J., Kim, J.-H., Arvis, C. D., Ahn, M.-J., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(15)01281-7 · Cited by 6,449
Pembrolizumab for the Treatment of Non–Small-Cell Lung Cancer
Garon, E. B., Rizvi, N. A., Hui, R., Leighl, N., Balmanoukian, A. S., Eder, J. P., Patnaik, A., Aggarwal, C., Gubens, M., Horn, L., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1501824 · Cited by 6,198
Research works printed but not linked: 8
- Ridolfi L, 2011, Int J Oncol, 39, 1011
- Chang JW, 2008, Chang Gung Med J, 31, 559
- Non-Small Cell Lung Cancer Collaborative Group, 2010, Cochrane Database Syst Rev, 5, CD007309
- Finn JW, 2002, Proc Am Soc Clin Oncol, 21, 154s
- Krakauer E, Presented at the American Society of Clinical Oncology Multidisciplinary Cancer Management Course
- McGuire L, 1990, Pharos, 53, 6
- Mead H, 2008, Health Care: A Chartbook
- Piccirillo JF, 2003, J Registry Manage, 30, 8
Cited by
Sorted by citations
The biology and management of non-small cell lung cancer
Herbst, R. S., Morgensztern, D., & Boshoff, C. (2018) · Nature · doi:10.1038/nature25183 · Cited by 4,891
Osimertinib or Platinum–Pemetrexed in EGFR T790M–Positive Lung Cancer
Mok, T. S., Wu, Y.-L., Ahn, M.-J., Garassino, M. C., Kim, H. R., Ramalingam, S. S., Shepherd, F. A., He, Y., Akamatsu, H., Theelen, W. S. M. E., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1612674 · Cited by 3,379
Lung cancer: current therapies and new targeted treatments
Hirsch, F. R., Scagliotti, G. V., Mulshine, J. L., Kwon, R., Curran, W. J., Wu, Y.-L. L. C., & Paz-Ares, L. G. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30958-8 · Cited by 3,430
Coudray, N., Ocampo, P. S., Sakellaropoulos, T., Narula, N., Snuderl, M., Fenyö, D., Moreira, A. L., Razavian, N., & Tsirigos, A. (2018) · Nature Medicine · doi:10.1038/s41591-018-0177-5 · Cited by 2,930
First-Line Nivolumab in Stage IV or Recurrent Non–Small-Cell Lung Cancer
Carbone, D. P., Reck, M., Paz-Ares, L., Creelan, B., Horn, L., Steins, M., Felip, E., van den Heuvel, M. M., Ciuleanu, T.-E., Badin, F., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1613493 · Cited by 2,503
Metadata
- Authors
- Masters, G. A., Temin, S., Azzoli, C. G., Giaccone, G., Baker, S., Brahmer, J. R., Ellis, P. M., Gajra, A., Rackear, N., Schiller, J. H., Smith, T. J., Strawn, J. R., Trent, D., & Johnson, D. H.
- Affiliations
- Christiana Care Health System (US)
- American Society of Clinical Oncology (US)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2015-10-20
- Volume
- 33
- Issue
- 30
- Pages
- 3488-3515
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC5019421
- OpenAlex
- W2125665528
- Cited by
- 850
- References
- 176
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 40 · 2023: 42 · 2022: 83 · 2021: 107 · 2020: 120 · 2019: 115 · 2018: 135 · 2017: 116 · 2016: 75 · 2015: 4
- FWCI
- 87.12
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-04-10)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
- Keywords
- stage IV non-small cell lung cancer, systemic therapy, EGFR mutation, ALK rearrangement, ROS1 rearrangement, large cell neuroendocrine carcinoma, first-line therapy, second-line therapy, third-line therapy, maintenance therapy, pemetrexed, bevacizumab, crizotinib, ceritinib, erlotinib, gefitinib, afatinib, platinum-based chemotherapy, palliative care, performance status
- MeSH terms
- Carcinoma, Non-Small-Cell Lung, Humans, Lung Neoplasms, Neoplasm Staging, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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