Adjuvant Cisplatin and Vinorelbine for Completely Resected Non-small Cell Lung Cancer: Subgroup Analysis of the Lung Adjuvant Cisplatin Evaluation

Abstract

In subgroup analyses, adjuvant cisplatin-vinorelbine provides a superior survival benefit and can be recommended in completely resected stages II and III non-small cell lung cancer.

Tratamento adjuvante em câncer de pulmão de células não pequenas

“…That analysis used data from four clinical trials, collectively involving 1,888 patients. In fact, those results are more consistent than are the results of other metaanalyses compared in the same study, (15) which allowed the use of other chemotherapy regimens (HR = 0.95; 95% CI: 0.86-1.05; interaction test = 0.04). The median survival described in the present study, as well as that described in the Arriagada et al study, (8) is clearly lower than the median survival of 94 months described in the study conducted by Winton et al (12) However, caution is required when comparing these results, because differences in patient selection are likely to have influenced this evaluation.…”

“…In another study, (14) this improvement was 11% after more than nine years of follow-up, which is in disagreement with the findings of the Arriagada et al study. (11) In addition, in a recent meta-analysis, (15) extremely positive results were obtained with the cisplatinvinorelbine combination, with a reduction in the overall mortality rate of 8.9% in comparison with observation (hazard ratio [HR] = 0.80; 95% CI: 0.70-0.91; p < 0.001). That analysis used data from four clinical trials, collectively involving 1,888 patients.…”

“…(10) major clinical trials and meta-analyses failed to demonstrate any benefit of the treatment. In one meta-analysis, (15) the absolute improvement, although not statistically significant, was 1.8% in such a subgroup (HR = 1.0; 95% CI: 0.78-1.30). Apparently, patients with tumors larger than 4 cm can benefit from adjuvant therapy, as has been observed in subgroup analyses of two studies.…”

Feasibility of adjuvant chemotherapy with S-1 consisting of a 4-week administration and a two-week rest period in patients with completely resected non-small cell lung cancer

“…Cisplatin (CDDP)-based chemotherapies are recommended as the adjuvant chemotherapy in surgically resected stage II and IIIA NSCLC (4,5). Among the CDDP-based combination chemotherapies, chemotherapy with CDDP and vinorelbine haveproven to be beneficial for survival in NSCLC (6). Kato et al (7) and Hamada et al (8) demonstrated that tegafur-uracil (UFT) adjuvant therapy improved the overall survival period in stage I lung adenocarcinoma, however, this result has not yet been proven worldwide.…”

Post-operative Treatment with Cisplatin and Vinorelbine in Chinese Patients with Non-small Cell Lung Cancer: A Clinical Prospective Analysis of 451 Patients

“…Furthermore, the ANITA (Adjuvant Navelbine International Trialist Association) and JBR-10 (National Cancer Institute of Canada Clinical Trial Group) trials also confirm the survival benefit of adjuvant cisplatinvinorelbine chemotherapy in patients with NSCLC at I-IIIA even after follow-up for 9.3 years (Winton et al, 2005;Douillard et al, 2006;Butts et al, 2010). In addition, the LACE (Lung Adjuvant Cisplatin Evaluation) collaborative group and ISA (Italian Survey on adjuvant treatment trial) independently confirm that the effect of NP treatment was significantly better than that of platinumbased combination Douillard et al, 2010;Banna et al, 2011). Interestingly, chemotherapy with uracil-tegafur, an alternative of cisplatin-based adjuvant therapy, also improves the survival rate in Japanese patients with NSCLC (Imaizumi et al, 2005;Nakagawa et al, 2006).…”