ASCO 2019 — Adjuvant chemotherapy beneficial in early, high-risk NSCLC


  • Hao Cheng, MD
  • Oncology Conference reports
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Takeaway

  • Adjuvant chemotherapy (ACT) may improve survival in patients with pathological stage I NSCLC who have high risk factors for recurrence.

Why this matters

  • Use of ACT in stage I NSCLC is controversial.
  • This study investigated benefit in certain tumors with high-risk factors for recurrence.

Study design

  • 1278 patients with pathological stage I NSCLC undergoing lobectomy were prospectively analyzed for high-risk factors and retrospectively analyzed for differential recurrence-free survival (RFS), OS, and cancer-specific survival (CSS) with and without ACT.
  • High-risk factors are defined as invasive component size >2 cm, lymphatic permeation, vascular invasion, or visceral pleural invasion.

Key results

  • 305 patients received ACT; 37.4% received platinum doublets, and 62.6% received monotherapy with oral fluoropyrimidines or others.
  • The high-risk group (n=641) had significantly worse RFS (P<.0001 and os than the low-risk group.>
  • Low-risk group: ACT showed no significant benefit in RFS (P=.30), OS (P=.35), or CSS (P=.52).
  • High-risk group: ACT yielded significant benefit in RFS (P=.023), OS (P<.0001 and css>

Limitations

  • Nonrandomized.