Drug delivery and toxicity of adjuvant chemotherapy for non-small cell lung cancer (NSCLC): Washington University experience

Velcheti, Vamsidhar; Viswanathan, Avinash; Baggstrom, Maria Q.; Govindan, Ramaswamy

doi:10.1080/02841860701218667

Cited by 2 publications

(6 citation statements)

References 8 publications

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“…Moreover, AC related toxic death was low in randomized clinical trials with a rate ranging from 0.8% to 2% (Table 1). Similar observations were reported according to retrospective studies in real-life practice (18,40,62,64,65,69). Indeed, 0.009% to 1.6% related AC toxicity death were reported by Massard et al (18) and Booth et al (62) respectively, while other retrospective studies reported no AC toxic death (40,64,65,69).…”

Section: Ac Related Toxicitiessupporting

confidence: 86%

“…Similar observations were reported according to retrospective studies in real-life practice (18,40,62,64,65,69). Indeed, 0.009% to 1.6% related AC toxicity death were reported by Massard et al (18) and Booth et al (62) respectively, while other retrospective studies reported no AC toxic death (40,64,65,69). In this context, predictors of early mortality (i.e., within 6 months following AC administration) have been identified (71).…”

Section: Ac Related Toxicitiessupporting

confidence: 86%

“…For 7% of the patients, the delay to initiate AC exceeded 60 days in the IALT trial (2). In non-trial setting, several retrospective studies were interested in the median time from surgery to AC administration (32,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). In real-life practice, these retrospective studies showed that the delay of initiation of AC did not differ significantly compared to clinical trials (Table 4).…”

Section: Delay Of Initiation Of Ac In Real-life Practice and Impact On Survivalmentioning

confidence: 99%

“…Although heterogeneity data (18,22,41,68,70), the number of patients who completed four cycles of AC ranged from 71% to 92% in non-trial setting (Table 6). In particular, the percentage of patients who received the total planned dose ranged from 40% (40) to 78.4% (34). Moreover, patients experience dose reduction or omission in a range of 40% (63) to 64% (62) (Table 6).…”

Section: Which Type Of Chemotherapy Is Used In Real-life Practice? Are Patients Received the Planned Dose Of Ac?mentioning

confidence: 99%

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Use of adjuvant chemotherapy in resected non-small cell lung cancer in real-life practice: a systematic review of literature

Désage¹,

Bouleftour²,

Tiffet³

et al. 2021

Transl Lung Cancer Res

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Background: Adjuvant chemotherapy (AC) is recommended since 2004 for patients with a completely resected non-small cell lung cancer (NSCLC). Indeed, several randomized clinical trials have demonstrated an improved survival for patients treated with adjuvant cisplatin-based regimen than surgery alone. In these large clinical trials, patients were well selected and fit to receive AC. As the benefit of AC was estimated at 5.4% of 5-year overall survival (OS), it seems important to evaluate AC use in a less selected population. In particular, elderly patients were underrepresented in large randomized clinical trials. Furthermore, other confounding factors might limit AC efficacy in real-life practice such as the delay of chemotherapy initiation following lung surgery or the number of AC cycles received. Therefore, the aim of this systematic review is to summarize the state of the literature on AC use in current clinical practice.Methods: A systematic assessment of literature articles and reviews on AC use in real-life practice was performed by searching in several relevant database including Medline, Google Scholar and Cochrane Library following PICOS eligibility criteria and PRISMA guidelines. Among the 1,957 results obtained with the request formulated on these research database, 56 relevant articles on AC use in non-trial setting were selected and included in the results section.Results: This systematic literature review highlights the lack of literature on AC use in real-life practice as most of these studies were retrospective. Interestingly, a delayed AC-mostly due to postoperative complications-was better than surgery alone. Furthermore, AC was less purposed to elderly patients, despite retrospective studies outlined that this therapeutic option could be benefit in this specific population as for younger patients. In real-life practice, AC was also often incomplete due to adverse events, but dose reduction or omission was not always associated with an inferior survival. In non-trial setting, number of AC cycles delivered, dose reduction or omission is quite similar to randomized clinical trials.Discussion: Nowadays, AC is part of the therapeutic strategy used in completely resected NSCLC. In a population of less selected patients, this systematic literature review shows that AC can be used safely and efficiently, especially in elderly patients. As well, delayed AC seems effective. Finally, the place of immunotherapy and targeted therapies have to be precised in the future as well as biomarkers to better select patients that would response to chemotherapy.

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Section: Ac Related Toxicitiessupporting

confidence: 86%

Section: Ac Related Toxicitiessupporting

confidence: 86%

Section: Delay Of Initiation Of Ac In Real-life Practice and Impact On Survivalmentioning

confidence: 99%

Section: Which Type Of Chemotherapy Is Used In Real-life Practice? Are Patients Received the Planned Dose Of Ac?mentioning

confidence: 99%

See 2 more Smart Citations

Use of adjuvant chemotherapy in resected non-small cell lung cancer in real-life practice: a systematic review of literature

Désage¹,

Bouleftour²,

Tiffet³

et al. 2021

Transl Lung Cancer Res

View full text Add to dashboard Cite

show abstract

“…There are limited published studies providing real-world patient data on the safety and patient outcomes associated with adjuvant chemotherapy in NSCLC [ 12 , 13 ]. With this study, we aimed to characterise patients undergoing adjuvant chemotherapy for resected NSCLC in a tertiary cancer center, and to describe disease-specific outcomes and treatment toxicity in a real-world patient population.…”

mentioning

confidence: 99%

Real-World Outcomes and Toxicity of Adjuvant Chemotherapy in NSCLC: a Single-Center Experience

et al. 2023

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Aim: Adjuvant chemotherapy in NSCLC is associated with modest benefits and significant toxicity. We sought to evaluate the toxicity of adjuvant chemotherapy and disease-specific outcomes in a real-world population. Methods: We performed a retrospective analysis of patients undergoing adjuvant chemotherapy for NSCLC in an Irish center over a 7-year period. We described treatment-associated toxicity, recurrence-free survival and overall survival. Results: 62 patients underwent adjuvant chemotherapy. Treatment-associated hospitalisation occurred in 29% of patients. Relapse was recorded in 56% of patients and median recurrence-free survival was 27 months. Conclusion: High rates of disease recurrence and treatment-associated morbidity were observed in patients receiving adjuvant chemotherapy for NSCLC. Novel therapeutic strategies are required to improve outcomes in this population.

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Drug delivery and toxicity of adjuvant chemotherapy for non-small cell lung cancer (NSCLC): Washington University experience

Cited by 2 publications

References 8 publications

Use of adjuvant chemotherapy in resected non-small cell lung cancer in real-life practice: a systematic review of literature

Use of adjuvant chemotherapy in resected non-small cell lung cancer in real-life practice: a systematic review of literature

Real-World Outcomes and Toxicity of Adjuvant Chemotherapy in NSCLC: a Single-Center Experience

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