Supplementation with selenium in patients with Stage IA and IB non-small cell lung cancer does not appear to prevent a second primary lung cancer from developing, according to the results of a Phase III study presented at the 2010 annual meeting of the American Society of Clinical Oncology.

Lung cancer remains the leading cause of cancer death in the United States. Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Although treatment with surgery is effective for many patients with Stage I NSCLC, some patients will eventually experience a second primary (new) lung cancer.

Previous studies have indicated that selenium supplementation may offer a preventive effect against lung cancer. In order to further evaluate this theory, the Eastern Cooperative Oncology Group conducted a randomized, double-blind study between 2000 and 2009. The study included 1,522 patients with stage IA and IB NSCLC that had been surgically removed. Patients had to be cancer free for at least six months after surgery in order to participate in the study. Patients were randomized to receive selenium (200 micrograms daily) or placebo for four years. Twice as many patients received selenium as placebo.

This study was stopped early when the interim data indicated that selenium offered no benefit over placebo. The five-year progression-free survival was 78% among patients receiving placebo compared with 72% in those receiving selenium. The data indicated that about 1.9% of patients in the selenium group developed a second primary lung tumor after one year compared with 1.4% in the placebo group. Overall, approximately 4.1% of patients in the selenium group developed a second primary tumor (of any type) in the first year compared with 3.7% in the placebo group. Side effects were minimal.

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The researchers concluded that selenium was safe, but did not offer any benefit over placebo.

Reference: Karp DD, Lee SJ, Shaw GL, et al. A phase III intergroup randomized double blind chemoprevention trial of selenium (Se) supplementation in resected stage I non small cell lung cancer (NSCLC). Presented at the 2010 annual meeting of the American Society of Clinical Oncology. June 4-8, 2010. Chicago, IL. Abstract CRA 7004.

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