According to an early online publication in the Lancet Oncology, the chemotherapy combination consisting of Navelbine® (vinorelbine) and Platinol® (cisplatin) following surgery improves survival over surgery alone in some patients with early lung cancer.
Lung cancer remains the leading cause of cancer related deaths in the United States. Lung cancer claims more lives every year that breast cancer, colon cancer, and prostate cancer combined. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer; “non–small cell” refers to the type of cell within the lung where the cancer originated.
Early lung cancer refers to cancer that has not spread to distant sites in the body from the lung. The extent of spread of cancer is referred to as the stage.
Stage I NSCLC refers to cancer that is located in only one lung and has not spread to the adjacent lymph nodes or outside the chest.
Stage II NSCLC refers to cancer that is located in one lung and may involve lymph nodes on the same side of the chest but does not include lymph nodes in the space between the lungs (the mediastinum) or outside the chest.
Stage IIIA NSCLC refers to cancer that is a single tumor or mass and is not invading any adjacent organs. It involves one or more lymph nodes away from the tumor but not outside the chest.
Debate has been ongoing regarding the benefits of chemotherapy following the surgical removal of cancer among patients with early lung cancer. To date, it appears that certain subsets of patients may experience improved survival with chemotherapy. Researchers are attempting to identify these patients.
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Researchers from France recently conducted a clinical trial to evaluate the effectiveness of Navelbine/Platinol in the treatment of patients with early NSCLC. This trial included 840 patients with Stages I-III NSCLC who were treated with surgery alone or surgery followed by Navelbine/Platinol.
- At five and seven years, overall survival was improved by nearly 9% among patients treated with chemotherapy.
- Two percent of patients died from treatment-related causes in the chemotherapy group. (However, the authors stated that relatively high doses of the chemotherapy were used.)
- The most common severe side effects from chemotherapy included low levels of immune cells, low levels of red blood cells, and low levels of immune cells accompanied by fever.
- Patients who derived the greatest benefit from chemotherapy were those with Stage II and IIIA disease.
The researchers concluded that the addition of Navelbine/Platinol to surgery appears to improve survival among patients with early NSCLC, particularly those with Stage II and IIIA disease. Genetic assessments of these patients are underway to help identify those who may achieve benefit from chemotherapy.
Patients with early NSCLC may wish to speak with their physician regarding their individual risks and benefits of chemotherapy.
Reference: Douillard J, et al. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomized controlled trial. Lancet Oncology. Early online publication. August 16, 2006. DOI: 10.1016/s1470-2045(06)70804-x.
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