Impact of AferBio® on Quality of Life and Chemotherapy Toxicity in Lung Cancer Patients

Inclusion Criteria: * Age above or equal to 18 years, and below 75 years; * Diagnosis of metastatic or recurrent NSCLC, beginning second-line palliative mono-chemotherapy treatment; * Functional capacity (ECOG-PS) grade 0 - 2; * Adequate hematological, kidney and liver function, as follows: * Total neutrophil count ≥ 1500/μL * Platelet count ≥ 100.000/μL * Hemoglobin ≥ 9 g/dL * Serum bilirubin ≤ 1.5 × upper limit of normal (ULN) * Patients with confirmed Gilbert's syndrome and serum bilirubin ≤ 3 × ULN * Aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase ≤ 1.5 × ULN, serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min based on the Cockcroft-Gault equation: (140 - age) × (weight in Kkg) × (0.85) 72 × (serum creatinine in mg/dL) * Absence of any emotional, family-related, sociological, or geographic condition that can potentially hamper adherence to the study protocol and the follow-up schedule; * Capacity and willingness to adhere to the study visits and tests, and to adhere to the protocol, according to the researcher's evaluation. Exclusion Criteria: * Tube feeding, gastrostomy- or jejunostomy; * Uncontrollable vomiting; * Sexually active women of reproductive age, except for those who underwent surgical sterilization (e. g., tubal ligation); * Intestinal obstruction or sub-obstruction; * Known allergy to any of the components of the investigational product; * Malabsorption syndrome or other condition that could interfere with enteric absorption; * History of inflammation of the small or large intestine, previous or currently active (such as Crohn's disease or ulcerative colitis); * Chronic diarrhea of any cause; * Diagnosis of any chronic disease that, in the researcher's opinion, will interfere with the participation in the study; * Known diagnosis of HIV -infection; * Diagnosis of any chronic disease that changes the immune system and significantly increases the risk of infection; * The need to use G-CSF already in the first chemotherapy cycle; * Severe neuropsychiatric disease that prevents the patient from completing the study questionnaires, determined at the researcher's discretion.