Adjuvant chemotherapy rates, survival rates increasing among NSCLC patients
medwireNews: Use of adjuvant chemotherapy (AC) in patients with non-small-cell lung cancer (NSCLC) has increased over time and is associated with a significant survival benefit, report researchers.
The findings emerge from a study of 4929 NSCLC patients with American Joint Committee on Cancer stages IB to IIIA disease who were treated surgically between 2001 and 2008. And while just over a fifth of patients overall received AC, the frequency of AC use increased “dramatically” from 7% in 2001–2003, to around 30% in later years.
In line with this, AC was associated with improved survival in the years after 2003, with hazard ratios (HRs) of 0.78 for the period 2004–2005 and 0.79 for 2006–2008.
Evidence for the impact of AC on survival has been lacking in large population-based cohorts until now, note Christina Williams, from Durham VA Medical Center in North Carolina, USA, and colleagues, who add that “[t]ogether, these findings indicate that clinical trial results regarding adjuvant chemotherapy benefit are applicable in less selective populations and support the use of AC in routine clinical practice.”
A total of 22% of patients in the cohort received postoperative AC, and the overall 4-year survival rate increased by around 7% between 2001–2003 and 2006–2008, the team reports in Cancer.
AC was associated with survival benefits across all stages of disease, but most prominently so for those with stage II disease, who had a HR of 0.77, compared with 0.82 for those with stage IIIA and 0.85 for those with stage IB disease.
The research team observed similar overall survival benefits for patients taking cisplatin-based AC as for those who received carboplatin, despite the fact that the latter was the more frequently administered agent. Indeed, carboplatin use increased from 73% during 2001 to 2003, to 90% in 2004 to 2005. However, its use was lower in the later years of the study, at 57% during 2006–2008.
Conversely, cisplatin use increased by 16% between 2001–2003 and 2006–2008.
The researchers highlight that the nonplatinum agent that is paired with carboplatin or cisplatin may contribute to the survival benefit for NSCLC patients who receive AC. Ongoing phase III trials “may provide insight regarding the optimal drug combination and change current guidelines and practice patterns for AC in patients with resected NSCLC”, they conclude.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2014
By Sarah Pritchard, medwireNews Reporter