Quelle place reste-t-il pour la chirurgie dans les cancers bronchiques de stade IIIA-N2 ?

Pagès, Pierre-Benoît; Pforr, Arnaud; Delpy, Jean-Philippe; Hanna, Halim Abou; Bernard, Alain

doi:10.1016/j.rmr.2014.07.016

Cited by 1 publication

(1 citation statement)

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“…Mediastinal lymph node-positive stage IIIA non-small cell lung cancer (NSCLC), confirmed either preoperatively or by postoperative pathology, is associated with poor prognosis [ 1 ]. Neoadjuvant chemotherapies modestly suppress stage IIIA NSCLC in some patients [ 2 – 4 ]. The antiangiogenic agent Endostar specifically inhibits the migration of, and induces apoptosis in, endothelial cells in new vessels [ 5 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Combining antiangiogenic therapy with neoadjuvant chemotherapy increases treatment efficacy in stage IIIA (N2) non-small cell lung cancer without increasing adverse effects

Zhao

You

et al. 2016

Oncotarget

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To evaluate the safety and efficacy of combining Endostar antiangiogenic therapy with neoadjuvant chemotherapy for the treatment of stage IIIA (N2) NSCLC, we conducted a randomized, controlled, open-label clinical study of 30 NSCLC patients. Patients were randomly assigned to the test or control groups, which received either two cycles of an NP neoadjuvant chemotherapy regimen combined with Endostar or the NP regimen alone, respectively, at a 2:1 ratio. Efficacy was assessed after 3 weeks, and surgical resection occurred within 4 weeks, in the 26 patients who successfully completed treatment. While total response rates (RR) and clinical benefit rates (CBR) did not differ between the experimental groups, total tumor regression rates (TRR) were higher in the test group than in the control group. Median DFS and OS also did not differ between the test and control groups. Clinical perioperative indicators, including intraoperative blood loss, number of dissected lymph node groups, duration of postoperative indwelling catheter use, and time to postoperative discharge, were comparable in the test and control groups. Finally, hematological and non-hematological toxicities and postoperative pathological indicators, including down-staging ratio, complete resection ratio, and metastatic lymph node ratio, also did not differ between the groups. Overall, combining Endostar with NP neoadjuvant chemotherapy increased therapeutic efficacy without increasing adverse effects in stage IIIA-N2 NSCLC patients. This study is registered with ClinicalTrials.gov (number NCT02497118).

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Section: Introductionmentioning

confidence: 99%