UFT Following Surgery Improves Survival in Stage I Non-Small Cell Lung Cancer

Cancer Connect

According to a recent article published in The New England Journal of Medicine, the chemotherapy regimen of Uracil and Tegafur following surgery improves survival over surgery alone in stage I non-small cell lung cancer.

Lung cancer remains the leading cause of cancer deaths annually in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type of cell within the lung that cancer originated. Patients with NSCLC that are treated prior to the spread of cancer have significantly improved long-term outcomes compared to patients with NSCLC treated after the cancer has spread to several and/or distant sites in the body. Stage I NSCLC refers to cancer that has not spread from its site of origin. Treatment for stage I NSCLC is comprised of surgery, if possible, with or without chemotherapy and/or radiation therapy. Adjuvant therapy refers to therapy utilized following surgery, and is used to kill any cancer cells that may be remaining in the body following surgery. Researchers continue to evaluate the effectiveness of adjuvant chemotherapy in the treatment of stage I NSCLC.

Researchers from The West Japan Study Group for Lung Cancer Surgery recently conducted a clinical trial to evaluate adjuvant chemotherapy with uracil and tegafur (UFT) in patients with stage I NSCLC. Tegafur is converted by the body into the active form of the chemotherapy agent 5-fluorouracil, and uracil enhances active levels of the agent in the body. This trial included nearly 1,000 patients diagnosed with stage I NSCLC who had their cancer completely surgically removed. Approximately half of the patients were treated with adjuvant UFT following surgery, and the other half were treated with surgery only (observation only). Approximately 73 months following therapy, overall survival was significantly improved in the group of patients treated with adjuvant UFT. Survival was 88% overall in patients treated with adjuvant UFT, compared to 85% in patients in the observation group. However, patients diagnosed with T2 (T refers to the size of the tumor and how far it has spread within the lung or nearby organs) NSCLC had an overall survival of 85% in the group treated with UFT, compared with 74% in the observation group. Patients who developed a cancer recurrence of a second cancer occurred at a rate of 23% in the UFT group, compared to 26% in the observation group.

The researchers concluded that adjuvant UFT improves survival in patients with stage I NSCLC that has been completely removed by surgery, particularly those with T2 NSCLC. Patients with stage I NSCLC may wish to speak with their physician about the risks and benefits of participation in a clinical trial further evaluating adjuvant therapy with UFT, as it is not approved by the FDA in the United States. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com. Personalized clinical trial searches are also performed by cancerconsultants.com.

Reference: Kato H, Ichinose Y, Ohta M, et al. A randomized Trial of Adjuvant Chemotherapy with Uracil-Tegafur for Adenocarcinoma of the Lung. The New England Journal of Medicine. 2004;350:1713-172.

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