title: Lung cancer working group report.
abstract: Asia needs a guideline for non-small-cell lung cancer because of differences in medical care, medical care insurance, ethnic variation and drug approval lag within Asian countries and compared with Western countries. Due to ethnic differences, drug dosages are often higher in the USA than in Japan. EGFR mutation in non-small-cell lung cancer was detected in 32% of Asians but only 6% of non-Asians, while differences in irinotecan metabolism cause higher frequencies of toxicity (leukopenia, diarrhea) in Asians. Pharmacodynamic ethnic differences in relation to paclitaxel/carboplatin resulted in longer median survival and a higher 1-year survival rate for Japanese-advanced non-small-cell lung cancer patients compared with Americans. To solve the problem of drug lag, pharmaceutical companies must perform multinational Asian clinical trials with quick accrual of patients, while regulatory authorities must establish high-quality, efficient approval processes, and achieve regulatory harmonization. The National Comprehensive Cancer Network promotes creation of national clinical practice guidelines, and Korea, China and Thailand adapted the National Comprehensive Cancer Network guidelines. Many Asian countries still lack such guidelines, and there are no pan-Asian guidelines for non-small-cell lung cancer. Japan developed its own non-small-cell lung cancer guidelines and also a gefitinib guidance. The study group members concluded that immediate establishment of an Asian non-small-cell lung cancer guideline will be difficult because of the differences among the countries. Asian collaborative trials on treatment of non-small-cell lung cancer need to be started at an early date to generate Asian data.
authors.affiliation: Medical Oncology Division, Kinki University School of Medicine, 377-2 Ono-Higashi, Osaka-Sayama City, Osaka 589-8511, Japan. nsaijo@med.kindai.ac.jp
authors.forename: Nagahiro
authors.initials: N
authors.lastname: Saijo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuoka
authors.forename: Sumitra
authors.initials: S
authors.lastname: Thongprasert
authors.forename: Yukito
authors.initials: Y
authors.lastname: Ichinose
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitsudomi
authors.forename: Tony Shu Kam
authors.initials: TS
authors.lastname: Mok
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ohe
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wu
mesh_terms: D001208:Asia; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D018773:Genes, erbB-1; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D017410:Practice Guidelines as Topic