According to an article recently published in the Journal of Clinical Oncology, the addition of disease stabilization to complete and partial responses at eight weeks appears to predict long-term outcomes more accurately than the standard measurement of responses for patients with advanced non–small cell lung cancer.
Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for approximately 75–80% of all lung cancers. “Non–small cell” refers to the type of cell within the lung where the cancer originated. Advanced NSCLC refers to cancer that has spread from the lung to lymph nodes or distant sites in the body. Standard therapy for advanced NSCLC typically includes chemotherapy.
Measurements of the size and locations of cancer on scans are used to determine if the cancer is responding to therapy. Partial responses (often defined as at least a 50% reduction in cancer) and complete responses (often defined as non-detectable cancer) are considered by most healthcare provider to be successful responses to therapy. As well, partial and complete response rates are often associated with long-term survival. More patients, however, have diseased stabilized through therapy than achieve responses. Because patients with disease stabilization have significant benefit from therapy, researchers have begun to pay more attention to disease stabilization as a measure of success of therapy.
Researchers affiliated with the Southwest Oncology Group (SWOG) recently evaluated data to explore the potential significance of disease stabilization in predicting outcomes for patients with lung cancer. The researchers evaluated data from previous trials in which 984 patients with advanced NSCLC were treated with platinum-based chemotherapy (Paraplatin® [Carboplatin] or Platinol® [cisplatin]). The researchers compared prediction of long-term outcomes with the standard measurement of complete responses plus partial responses (CR/PR) to that of disease stabilization plus CR/PR (disease control rate [DCR]) at eight weeks. Overall, the addition of disease stabilization to PR/CR provided greater accuracy in predicting long-term survival than PR/CR itself.
The researchers concluded: “DCR at week 8 is a more powerful predictor of subsequent survival than is the traditional tumor response rate in advanced NSCLC and provides an early assessment of subsequent outcome.”
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Reference: Lara P, Redman M, Kelly K, et al. Disease control rate at 8 weeks predicts clinical benefit in advanced non–small-cell lung cancer: Results From Southwest Oncology Group randomized trials. Journal of Clinical Oncology. 2008;26: 463-467.
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