Advances in adjuvant systemic therapy for non-small-cell lung cancer

Leong, David; Rai, Robba; Nguyen, Brandon; Lee, Andrew; Yip, Desmond

doi:10.5306/wjco.v5.i4.633

Cited by 17 publications

(13 citation statements)

References 68 publications

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“…Analysis of the data supporting adjuvant chemotherapy after surgery for NSCLC showed a small benefit of adjuvant chemotherapy of less than 5% at 5 years. These studies, however, had a small number of patients [25]. Moreover, we found no correlation between OS and adjuvant radiotherapy, which needs to be evaluated in particular cases, such as postoperative N2-NSCLC.…”

Section: Postoperative Complications and Mortalitymentioning

confidence: 64%

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Morgant

Pagès

Orsini³

et al. 2015

Eur Respir J

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The aim of this study was to assess the evolution of survival in patients treated surgically for non-small cell lung cancer (NSCLC) between 2005 and 2012.From January 2005 to December 2012, 34 006 patients underwent pulmonary resection for NSCLC and were included in the French national database Epithor. Patients' characteristics, procedures and survival were analysed. Survival according to the management was evaluated for each 2-year period separately: 2005-2006, 2007-2008, 2009-2010 and 2011-2012.The proportions of early-stage cancers and adenocarcinomas increased significantly over the periods. 3-year overall survival (OS) increased significantly from 80.5% for the first period to 81.4% for the last period. For the periods 2005-2006 and 2007-2008, 3-year OS was lower after segmentectomy than after lobectomy (77 and 73% versus 82 and 83%, respectively). For the periods 2009-2010 and 2011-2012, 3-year OS in the two sub-groups was similar. OS after bi-lobectomy or pneumonectomy was lower than after lobectomy for all periods analysed. Systematic nodal dissection increased OS for all periods. Chemotherapy but not radiotherapy improved OS in the first 12 postoperative months for all periods.Changes in histological type and stage linked to advances in surgical and medical practices since 2005 led to an increase in OS in patients with surgical-stage NSCLC. @ERSpublications Overall survival and postoperative mortality after lung cancer surgery improve over the last decades

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Section: Postoperative Complications and Mortalitymentioning

confidence: 64%

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Morgant

Pagès

Orsini³

et al. 2015

Eur Respir J

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“…New therapeutic modalities, such as minimally invasive surgery and targeted therapy, have been introduced to the treatment of lung cancer during the past decades. However, the overall 5-year survival of lung cancer patients has been improved very little, especially in the advanced diseases [2]. Immunotherapy has brought up new options for lung cancer patients, including blockade of immune checkpoints like cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death 1 (PD-1) [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of tumor-associated macrophage infiltration in non-small cell lung cancer: A systemic review and meta-analysis

et al. 2016

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Tumor-associated macrophages (TAMs) are important components of cancer microenvironment. In the present study, we searched PubMed, Embase, Cochrane library and Web of Science to perform a meta-analysis of 20 studies including a total of 2,572 non-small cell lung cancer (NSCLC) patients, in order to determine the association between TAMs and NSCLC prognosis. The combined hazard ratio (HR) of 9 studies showed that the density of total CD68+ TAMs in the tumor islet and stroma was not associated with overall survival (OS) of the patients. However, the pooled HR of 4 studies showed that high density of CD68+ TAMs in the tumor islet predicted better OS, while the pooled HR of 6 studies showed that high density of CD68+ TAMs in the tumor stroma was associated with poor OS. A high islet/stroma ratio of CD68+ TAMs was associated with better OS. A high density of M1 TAMs in the tumor islet was associated with better OS, while a high density of M2 TAMs in the tumor stroma predicted poor OS. These findings suggest that, although the density of total CD68+ TAMs is not associated with OS, the localization and M1/M2 polarization of TAMs are potential prognostic predictors of NSCLC.

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“…Several of these patients may have micro-metastases that are not able to be detected during pre- or intra-operative staging. Therefore, if such micro-metastases could be controlled using adjuvant modalities following surgery, it may be possible to improve the surgical outcomes of patients with stage IB to IIIA NSCLC ( 1 – 4 ). In fact, various large-scale phase III clinical trials have indicated that adjuvant combined platinum-based chemotherapy improved the overall survival (OS) and disease-free survival (DFS) rates of patients with completely resected NSCLC ( 5 – 8 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of in vitro chemosensitivity test-guided platinum-based adjuvant chemotherapy on the surgical outcomes of patients with p-stage IIIA non-small cell lung cancer that underwent complete resection

Akazawa

Higashiyama

Nishino

et al. 2017

Molecular and Clinical Oncology

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The impact of in vitro chemosensitivity test-guided platinum-based adjuvant chemotherapy on the surgical outcomes of patients undergoing complete resection for locally advanced non-small cell lung cancer (NSCLC) has yet to be elucidated. In the present study, the utility of adjuvant chemotherapy based on the collagen gel droplet embedded culture drug sensitivity test (CD-DST) in patients with p (pathology)-stage IIIA NSCLC was retrospectively analyzed. A series of 39 patients that had received platinum-based adjuvant chemotherapy following complete resection between 2007 and 2012 were enrolled. Their surgical specimens were subjected to the CD-DST. The patients were subsequently classified into two groups on the basis of in vitro anti-cancer drug sensitivity data obtained using the CD-DST: The sensitive group (25 patients) were treated with regimens including one or two of the anti-cancer drug(s) that were indicated to be effective by the CD-DST, whereas the non-sensitive group (14 patients) were treated with chemotherapy regimens that did not include any CD-DST-selected anti-cancer drugs. There were no significant differences in the background characteristics of the two groups [including in respect of the pathological TN (tumor-lymph node) stage, tumor histology, epidermal growth factor receptor mutation status, the frequency of each chemotherapy regimen, and the number of administered cycles]. The 5-year disease-free survival (DFS) rate of the sensitive group was 32.3%, whereas that of the non-sensitive group was 14.3% (P=0.037). In contrast, no difference in overall survival (OS) was observed (P=0.76). Multivariate analysis revealed that adjuvant chemotherapy based on the CD-DST had a significant favorable effect on the DFS (P=0.01). Therefore, the present study has demonstrated that CD-DST data obtained from surgical specimens aid the selection of effective platinum-based adjuvant chemotherapy regimens for patients undergoing complete resection for p-stage IIIA NSCLC. The use of CD-DST-guided platinum-based regimens may have a beneficial impact on the DFS of such patients.

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Advances in adjuvant systemic therapy for non-small-cell lung cancer

Cited by 17 publications

References 68 publications

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Prognostic impact of tumor-associated macrophage infiltration in non-small cell lung cancer: A systemic review and meta-analysis

Impact of in vitro chemosensitivity test-guided platinum-based adjuvant chemotherapy on the surgical outcomes of patients with p-stage IIIA non-small cell lung cancer that underwent complete resection

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