According to results recently presented at the 2007 annual meeting of the American Society of Clinical Oncology, meta-analysis that has been extended and updated provides further evidence that chemotherapy following surgery provides a survival advantage among patients with early non–small cell lung cancer.
Lung cancer remains the leading cause of cancer-related deaths worldwide. In the United States, non-small cell lung cancer (NSCLC), which refers to the type of cell within the lung where the cancer originated, accounts for 75–80% of all lung cancers. Early NSCLC means that cancer has not spread to distant sites in the body.
Adjuvant therapy refers to treatment administered following surgery. It is used to kill cancer cells that may be remaining in the body following surgery. The precise role of adjuvant chemotherapy in early NSCLC has remained controversial, as not all studies have indicated a positive impact from adjuvant chemotherapy in this stage of disease. As well, chemotherapy is associated with side effects that are difficult to tolerate for some patients. However, overall data has suggested an improved outcome with the use of adjuvant chemotherapy for early NSCL. Physicians have thus awaited more extensive data and longer follow-up on this treatment approach to provide more confirmatory evidence on its potential benefits.
Researchers from England recently conducted a study to evaluate more extensive and updated data regarding adjuvant chemotherapy in the treatment of NSCLC. This analysis included results from over 30 clinical trials including over 8,000 patients with early NSCLC. All studies involved in the analysis compared outcomes of patients who were treated with surgery plus adjuvant chemotherapy or surgery only. Chemotherapy included platinum-based regimens (containing Paraplatin® or Platinol®) or a combination of Tegafur/UFT, which is commonly used in Japan.
• At five years survival was 64% for patients treated with chemotherapy compared to 60% for patients treated with surgery only.
• Recurrence-free survival was improved for patients treated with chemotherapy, as was time to recurrences near or at the site of origin and recurrences at distant sites in the body.
The researchers concluded that adjuvant chemotherapy does improve survival for patients with early NSCLC. This updated and expanded analysis helps provide further evidence of the benefits of chemotherapy in this setting. However, because not all patients are eligible for chemotherapy, it is important for patients to speak with their physician regarding their individual risks and benefits of treatment with chemotherapy.
Reference: Stewart L, et al. Surgery and Adjuvant Chemotherapy (CT) Compared to Surgery Alone in Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis Using Individual Patient Data (IPD) from Randomized Clinical Trials (RCT). Proceedings from the 2007 annual meeting of the American Society of Clinical Oncology. Abstract # 7552.