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According to a recent article published in The New England Journal of Medicine, cisplatin (Platinol®)-based chemotherapy modestly increases overall and cancer-free survival following surgery in non-small cell lung cancer.

Lung cancer remains the leading cause of cancer deaths in the United States. Worldwide, it is estimated that approximately 900,000 people are diagnosed with lung cancer every year. Non-small cell lung cancer accounts for approximately 75% of lung cancers, and refers to the type of cell in which the cancer originated. Cancer that has not spread to several and/or distant sites in the body is often treated with surgery, with or without radiation therapy and/or chemotherapy. However, definitive results regarding optimal therapeutic strategies for lung cancer have not been clearly demonstrated and researchers continue to evaluate and refine treatment options for this disease. Following the complete surgical removal of cancer, patients may be treated with chemotherapy, which is referred to as adjuvant chemotherapy. Adjuvant chemotherapy is used in an attempt to kill any undetectable cancer cells that may be remaining in the body after surgery, as these cells would be responsible for a cancer recurrence. Several different chemotherapy agents and combinations of agents have been evaluated in clinical trials, with cisplatin remaining a common choice for adjuvant chemotherapy in lung cancer.

Researchers from The International Adjuvant Lung Cancer Trial Collaborative Group recently conducted a clinical trial to further evaluate cisplatin-based chemotherapy regimens used as adjuvant therapy following the complete surgical removal of stages I-III non-small cell lung cancer. This trial involved nearly 1,900 patients who were treated either with surgery plus cisplatin-based chemotherapy, or surgery alone (observation group). The chemotherapy regimens consisted of cisplatin plus one of the following chemotherapy agents: etoposide, vinorelbine, vinblastine or vindesine. Approximately 56 months following therapy, patients who had been treated with chemotherapy had a higher overall survival and cancer-free survival rate than the observation group. Overall survival was 44.5% in patients treated with chemotherapy, compared with 40.4% in the observation group. Cancer-free survival was 39.4% for patients treated with chemotherapy, compared to 34.4% for the observation group. Less than 1% of patients died from treatment-related complications in the chemotherapy group. The researchers could not find any variables between the two treatment groups that provided indications as to which patients may benefit most from treatment. Furthermore, these researchers suggested that 7,000 patients diagnosed with non-small cell lung cancer could be saved from death annually with the use of cisplatin-based adjuvant chemotherapy.

The researchers concluded that cisplatin-based chemotherapy improves overall and cancer-free survival in patients with surgically removed non-small cell lung cancer. Evaluation of results of a clinical trial including approximately 4,000 patients with non-small cell lung cancer who were treated with adjuvant cisplatin-based chemotherapy is underway, and may provide results in regards to specific patient or disease characteristics that are associated with prognostic significance. Furthermore, further clinical trials may shed light on the clinical effectiveness of adjuvant chemotherapy compared to pre-operative chemotherapy and/or the role of radiation therapy in patients with this disease.

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Reference: International Adjuvant Lung Cancer Trial (IALT) Collaborative Group. Cisplatin-Based Adjuvant Chemotherapy in Patients with Completely Resected Non–Small-Cell Lung Cancer.

The New England Journal of Medicine. 2003; 350:351-360.

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