***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES This study attempts to quantify the difference in loss of quality -adjusted life expectancy ( QALE ) for patients with operable and inoperable non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0 - 1 was monitored for 7 years ( 2005 - 2011 ) to obtain the survival function . This was further extrapolated to lifetime , based on the survival ratios between patients and age- and sex-matched referents simulated from the life tables of the National Vital Statistics of Taiwan . Between 2011 and 2012 , EuroQol 5-dimension question naires were used to prospect ively measure the quality -of-life ( QoL ) of a 518 consecutive , cross-sectional sub sample . We adjusted the lifetime survival function by the utility values of QoL for the cancer cohort to obtain the QALE , while that for the age and sex-matched referents were adjusted to the values collected from the 2009 National Health Interview Survey , and the difference between them was the loss-of-QALE . RESULTS The QALE for patients with operable and inoperable NSCLC were 11.66±0.18 and 1.43±0.05 quality -adjusted life year ( QALY ) , with the corresponding loss-of-QALE of 5.25±0.18 and 14.24±0.05 QALY , respectively . The lifetime utility difference for patients with operable and inoperable NSCLC was 9.00±0.18 QALY , after adjustment for QoL and lead-time bias . CONCLUSION The utility gained from surgical operation for operable lung cancer is substantial , even after adjustment for lead-time bias . Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessment s to improve patients ' values OBJECTIVES To evaluate the feasibility and adherence to home delivery ( HD ) of pemetrexed maintenance treatment in patients with advanced non-squamous non-small cell lung cancer ( nsqNSCLC ) . MATERIAL S AND METHODS Exploratory , prospect i ve , single-arm , Phase II study in advanced nsqNSCLC patients , with an Eastern Cooperative Oncology Group ( ECOG ) performance status of 0/1 that did not progress after 4 first-line induction cycles of a platinum doublet .  The first cycle of pemetrexed ( 500mg/m(2 ) ) was hospital administered , further cycles were HD until progressive disease or discontinuation . Feasibility was assessed by the adherence rate to HD ( probability of reversion to hospital administration or treatment discontinuation due to HD ) as primary endpoint , and by health-related quality -of-life ( HRQoL : EQ-5D , lung cancer symptom scale [ LCSS ] ) , satisfaction with HD , overall survival ( OS ) , and safety . RESULTS 52 patients ( UK & Sweden ) received a median of 4 ( range 1 - 19 ) pemetrexed maintenance cycles . Adherence rate up to Cycle 6 was 98.0 % ( 95 % confidence interval [ CI ] : 86.4 % , 99.7 % ) . All but 2 patients remained on HD . 1 patient discontinued after Cycle 1 ( patient decision ) , and 1 after Cycle 6 ( non-compliance with oral dexamethasone ) . 87 % ( 33/38 ) of the patients preferred home to hospital treatment and in 90 % ( 28/31 ) of cases , physicians were satisfied with distant management of patients . During HD Cycles 2 - 4 mean change from baseline ranged from 3.0 to 7.7 for EQ-5D visual analog scale . The 6-month OS rate was 73 % ( 95 % CI : 58 % , 83 % ) . 1 patient had an HD-related adverse event ( device-related infection , Grade 2 ) and 1 patient died after Cycle 1 , before HD , due to a possibly drug-related atypical pneumonia . CONCLUSION HD of pemetrexed maintenance treatment in patients with advanced nsqNSCLC was feasible , safe , and preferred by patients , while maintaining HRQoL. Physicians were satisfied with distant patient management Introduction : Necitumumab , a second‐generation , recombinant human immunoglobulin G1 epidermal growth factor receptor antibody in the phase 3 SQUIRE trial ( NCT00981058 ) , increased survival benefit for patients r and omized to receive necitumumab plus gemcitabine‐cisplatin compared with those who received gemcitabine‐cisplatin . Here we characterize health‐related quality of life ( HRQoL ) and tolerability results . Methods : A total of 1093 patients with stage IV squamous non – small cell lung cancer were r and omized 1:1 to receive necitumumab ( 800 mg absolute dose intravenously [ IV ] ) plus gemcitabine‐cisplatin ( gemcitabine = 1250 mg/m2 IV on days 1 and 8 ; cisplatin = 75 mg/m2 IV on day 1 ) or gemcitabine‐cisplatin alone ( every 21 days ) for up to six cycles . Patients receiving necitumumab plus gemcitabine‐cisplatin without disease progression continued necitumumab until progression . HRQoL was measured by Eastern Cooperative Oncology Group performance status , the Lung Cancer Symptom Scale ( LCSS ) , and the European Quality of Life Five‐Dimensions question naire . Efficacy and LCSS outcomes were analyzed using the baseline maximum severity score of the LCSS . Tolerability was measured in terms of exposure to the study treatment and adverse events . Hospitalization rates were collected . Results : Most patients in both study arms similarly maintained Eastern Cooperative Oncology Group performance status and comparable LCSS and European Quality of Life Five‐Dimensions question naire assessment s. Patients with a higher baseline LCSS had a greater survival benefit on the necitumumab arm . Chemotherapy exposure was similar in both treatment arms ; 51 % of patients on the necitumumab plus gemcitabine‐cisplatin arm continued on single‐agent necitumumab . The most frequent grade 4 adverse events were neutropenia ( 6.1 % versus 7.9 % ) and thrombocytopenia ( 3.2 % versus 4.3 % ) in the necitumumab plus gemcitabine‐cisplatin versus gemcitabine‐cisplatin arms , respectively . Hospitalizations were slightly higher with necitumumab plus gemcitabine‐cisplatin ( 36.4 % ) than with gemcitabine‐cisplatin ( 34.0 % ) . Conclusions : The addition of necitumumab to gemcitabine‐cisplatin was well tolerated , did not negatively affect HRQoL or toxicity , and particularly benefited patients with more severe baseline symptoms or lower BACKGROUND Atezolizumab is a humanised antiprogrammed death-lig and 1 ( PD-L1 ) monoclonal antibody that inhibits PD-L1 and programmed death-1 ( PD-1 ) and PD-L1 and B7 - 1 interactions , reinvigorating anticancer immunity . We assessed its efficacy and safety versus docetaxel in previously treated patients with non-small-cell lung cancer . METHODS We did a r and omised , open-label , phase 3 trial ( OAK ) in 194 academic or community oncology centres in 31 countries . We enrolled patients who had squamous or non-squamous non-small-cell lung cancer , were 18 years or older , had measurable disease per Response Evaluation Criteria in Solid Tumors , and had an Eastern Cooperative Oncology Group performance status of 0 or 1 . Patients had received one to two previous cytotoxic chemotherapy regimens ( one or more platinum based combination therapies ) for stage IIIB or IV non-small-cell lung cancer . Patients with a history of autoimmune disease and those who had received previous treatments with docetaxel , CD137 agonists , anti-CTLA4 , or therapies targeting the PD-L1 and PD-1 pathway were excluded . Patients were r and omly assigned ( 1:1 ) to intravenously receive either atezolizumab 1200 mg or docetaxel 75 mg/m2 every 3 weeks by permuted block r and omisation ( block size of eight ) via an interactive voice or web response system . Co primary endpoints were overall survival in the intention-to-treat ( ITT ) and PD-L1-expression population TC1/2/3 or IC1/2/3 ( ≥1 % PD-L1 on tumour cells or tumour-infiltrating immune cells ) . The primary efficacy analysis was done in the first 850 of 1225 enrolled patients . This study is registered with Clinical Trials.gov , number NCT02008227 . FINDINGS Between March 11 , 2014 , and April 29 , 2015 , 1225 patients were recruited . In the primary population , 425 patients were r and omly assigned to receive atezolizumab and 425 patients were assigned to  receive  docetaxel  .  Overall survival was significantly longer with atezolizumab in the ITT and PD-L1-expression population s. In the ITT population , overall survival was improved with atezolizumab compared with docetaxel ( median overall survival was 13·8 months [ 95 % CI 11·8 - 15·7 ] vs 9·6 months [ 8·6 - 11·2 ] ; hazard ratio [ HR ] 0·73 [ 95 % CI 0·62 - 0·87 ] , p=0·0003 ) . Overall survival in the TC1/2/3 or IC1/2/3 population was improved with atezolizumab ( n=241 ) compared with docetaxel ( n=222 ; median overall survival was 15·7 months [ 95 % CI 12·6 - 18·0 ] with atezolizumab vs 10·3 months [ 8·8 - 12·0 ] with docetaxel ; HR 0·74 [ 95 % CI 0·58 - 0·93 ] ; p=0·0102 ) . Patients in the PD-L1 low or undetectable subgroup ( TC0 and IC0 ) also had improved survival with atezolizumab ( median overall survival 12·6 months vs 8·9 months ; HR 0·75 [ 95 % CI 0·59 - 0·96 ] ) . Overall survival improvement was similar in patients with squamous ( HR 0·73 [ 95 % CI 0·54 - 0·98 ] ; n=112 in the atezolizumab group and n=110 in the docetaxel group ) or non-squamous ( 0·73 [ 0·60 - 0·89 ] ; n=313 and n=315 ) histology . Fewer patients had treatment-related grade 3 or 4 adverse events with atezolizumab ( 90 [ 15 % ] of 609 patients ) versus docetaxel ( 247 [ 43 % ] of 578 patients ) . One treatment-related death from a respiratory tract infection was reported in the docetaxel group . INTERPRETATION To our knowledge , OAK is the first r and omised phase 3 study to report results of a PD-L1-targeted therapy , with atezolizumab treatment result ing in a clinical ly relevant improvement of overall survival versus docetaxel in previously treated non-small-cell lung cancer , regardless of PD-L1 expression or histology , with a favourable safety profile . FUNDING F. Hoffmann-La Roche Ltd , Genentech , Background Second-line treatment of advanced non-small-cell lung cancer ( NSCLC ) improves overall survival . There is a lack of data regarding the impact on patients ' overall health condition . This prospect i ve , non-interventional study evaluated performance status ( PS ) and health-related quality of life ( HR-QoL ) during second-line pemetrexed treatment in routine clinical practice . Methods Stage III/IV NSCLC patients who initiated second-line pemetrexed ( st and ard vitamin and dexamethasone supplementation ) were observed for a maximum of 9 treatment cycles . The primary objective was to evaluate the proportion of patients achieving improvement of Karnofsky Index ( KI ) of ≥ 10 % ( absolute ) or maintaining KI ≥ 80 % after the second treatment cycle ( " KI benefit response " ) . HR-QoL was self-rated using the EuroQoL-5D question naire ( EQ-5D ) . Factors potentially associated with KI benefit response were evaluated using logistic regression models . Results Of 521 eligible patients ( 73.5 % Stage IV , median age 66.3 yrs , 36.1 % ≥ 70 yrs , 62.0 % with KI ≥ 80 % ) , 471 ( 90.4 % ) completed at least 2 treatment cycles . 58.0 % ( 95%CI 53.6%;62.2 % ) achieved KI benefit response after the second cycle . Patients with baseline KI ≥ 80 % , no Grade 3/4 toxicities during the first 2 cycles , or combination regimen as prior first-line therapy were more likely to achieve a KI benefit response . EQ-5D scores improved over time . Grade 3/4 toxicities were reported in 23.8 % of patients ( mainly fatigue/asthenia 15.9 % 
    Output:
    
The range of HSUVs identified for comparable health states showed how differences in study type , tariff , health state and the measures used can drive variation in HSUV estimates .