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Long-term results of the international adjuvant lung cancer trial evaluating adjuvant Cisplatin-based chemotherapy in resected lung cancer.

Arriagada, Rodrigo (author)
Karolinska Institutet
Dunant, Ariane (author)
Pignon, Jean-Pierre (author)
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Bergman, Bengt, 1953 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin,Institute of Medicine, Department of Internal Medicine
Chabowski, Mariusz (author)
Grunenwald, Dominique (author)
Kozlowski, Miroslaw (author)
Le Péchoux, Cécile (author)
Pirker, Robert (author)
Pinel, Maria-Izabel Sathler (author)
Tarayre, Michèle (author)
Le Chevalier, Thierry (author)
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 (creator_code:org_t)
2010
2010
English.
In: Journal of clinical oncology. - 1527-7755. ; 28:1, s. 35-42
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • PURPOSE Based on 5-year or shorter-term follow-up data in recent randomized trials, adjuvant cisplatin-based chemotherapy is now generally recommended after complete surgical resection for patients with non-small-cell lung cancer (NSCLC). We evaluated the results of the International Adjuvant Lung Cancer Trial study with three additional years of follow-up. PATIENTS AND METHODS Patients with completely resected NSCLC were randomly assigned to three or four cycles of cisplatin-based chemotherapy or to observation. Cox models were used to evaluate treatment effect according to follow-up duration. Results The trial included 1,867 patients with a median follow-up of 7.5 years. Results showed a beneficial effect of adjuvant chemotherapy on overall survival (hazard ratio [HR], 0.91; 95% CI, 0.81 to 1.02; P = .10) and on disease-free survival (HR, 0.88; 95% CI, 0.78 to 0.98; P = .02). However, there was a significant difference between the results of overall survival before and after 5 years of follow-up (HR, 0.86; 95% CI, 0.76 to 0.97; P = .01 v HR, 1.45; 95% CI, 1.02 to 2.07; P = .04) with P = .006 for interaction. Similar results were observed for disease-free survival. The analysis of non-lung cancer deaths for the whole period showed an HR of 1.34 (95% CI, 0.99 to 1.81; P = .06). CONCLUSION These results confirm the significant efficacy of adjuvant chemotherapy at 5 years. The difference in results beyond 5 years of follow-up underscores the need for the long-term follow-up of other adjuvant lung cancer trials and for a better identification of patients deriving long-term benefit from adjuvant chemotherapy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Keyword

Antineoplastic Combined Chemotherapy Protocols
therapeutic use
Carcinoma
Non-Small-Cell Lung
drug therapy
mortality
Cause of Death
Cisplatin
administration & dosage
Disease-Free Survival
Female
Humans
Lung Neoplasms
drug therapy
mortality
Male
Middle Aged

Publication and Content Type

ref (subject category)
art (subject category)

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