Chemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial1

Waller, David; Peake, Michael; Stephens, Richard; Gower, Nicole H.; Milroy, Robert; Parmar, Mahesh; Rudd, RM; Spiro, Stephen; ONBEHALFOFALLBLTPARTICIPANTS,

doi:10.1016/j.ejcts.2004.03.041

Cited by 346 publications

(197 citation statements)

References 11 publications

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“…4 Subsequent randomized trials investigating the role of AC in patients with localized NSCLC reported conflicting results. Although some trials have found no survival difference between patients who underwent surgical resection with and without AC, 5,6 3 large trials demonstrated a statistically and clinically significant survival benefit with cisplatin-based AC regimens, with 5-year survival differences ranging from 4% to 15%. [7][8][9] Of these, the International Adjuvant Lung Cancer Trial was to our knowledge the largest and first positive trial demonstrating both an overall and disease-free survival benefit with AC.…”

Section: Introductionmentioning

confidence: 99%

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Williams

Gajra

Ganti

et al. 2014

Cancer

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BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non‐small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8‐year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22% of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0%, 29.8%, and 29.5%, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95% CI, 0.67‐0.91) and 2006 through 2008 (HR, 0.79; 95% CI, 0.69‐0.91). Of those patients receiving AC, 89% received platinum‐doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43% in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95% CI, 0.80‐1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939–1947. © 2014 American Cancer Society.

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Section: Introductionmentioning

confidence: 99%

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Williams

Gajra

Ganti

et al. 2014

Cancer

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“…Therefore, adjuvant chemotherapy is needed for patients with NSCLC to prevent a relapse. A number of clinical trials have been conducted on adjuvant chemotherapy for patients with NSCLC to reduce the recurrence rate and prolong overall survival [4][5][6][7][8]. A meta-analysis of five trials that evaluated the effectiveness of adjuvant chemotherapy has reported that postoperative cisplatin-based chemotherapy significantly improved survival in patients with NSCLC [9].…”

Section: Ivyspringmentioning

confidence: 99%

The Factors Reducing Relative Dose Intensity of Cisplatin and Vinorelbine as Adjuvant Chemotherapy in Patients with Non-Small Cell Lung Cancer

Inose¹,

Takahashi²,

Yoshimura³

et al. 2018

Oncomedicine

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Purpose Adjuvant therapy with cisplatin and vinorelbine (CV therapy) is recommended for patients after complete surgical resection of stage II and IIIA non-small cell lung cancer (NSCLC). However, a dose reduction or early discontinuation of a subsequent course of treatment is a frequent clinical problem. The aim of this study was to investigate the factors reducing the relative dose intensity (RDI) of adjuvant CV therapy in patients with NSCLC. Methods Patients who had received CV as an adjuvant chemotherapy for NSCLC at the Osaka City University Hospital between July 2007 and March 2016 were identified from medical records. The patients were classified into two groups (RDI <50% and RDI ≥50%, respectively), and patients' characteristics, laboratory values, adverse reactions, and RDI of CV therapy were analyzed. The two groups were compared using the Fisher's exact test. Results The study population consisted of 25 patients. There were six patients (24.0%) with RDI <50% and 19 patients (76.0%) with RDI ≥50%. Univariate analysis showed that the use of calcium channel blockers [crude odd ratio (OR): 10.70; 95% confidence interval (CI): 1.31-86.94; p=0.032] and renal dysfunction (creatinine clearance <60 mL/min) (crude OR: 18.00; 95% CI: 1.37-235.70; p=0.031) were associated with the reduced RDI. Conclusion This study indicated that the renal dysfunction and concomitant use of calcium channel blockers might be predictive factors for reduced RDI of adjuvant CV therapy in patients with NSCLC. Patients with these factors may be able to avoid extreme reduction in RDI if the dose is reduced or the dosing interval is prolonged.

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“…A meta-analysis reveals a small benefit of adjuvant chemotherapy for patients with NSCLC after resection of the tumor, however, other randomized clinical trials show contradictory results. Data from the ALPI (Adjuvant Lung Project Italy) and BLT (Big Lung Trial) trials show that chemotherapy has no beneficial for the overall response rate and survival of patients with NSCLC at stage I-IIIA after follow-up for more than 5 years (Scagliotti et al, 2003;Waller et al, 2004). On the other hand, platinum-based chemotherapy is effective for patients with NSCLC in American and European countries.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Liu²,

Huang³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Chemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial1

Cited by 346 publications

References 11 publications

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

Use and impact of adjuvant chemotherapy in patients with resected non‐small cell lung cancer

The Factors Reducing Relative Dose Intensity of Cisplatin and Vinorelbine as Adjuvant Chemotherapy in Patients with Non-Small Cell Lung Cancer

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

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