SCLC: CRT yields better OS in stage I-II vs stage III disease

  • JAMA Oncol

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with stage I-II small cell lung cancer (SCLC) have significantly better OS and progression-free survival (PFS) after chemoradiotherapy (CRT) than patients with stage III disease.

Why this matters

  • The findings could help clinicians and SCLC patients choose the best course of therapy.

Study design

  • Post-hoc secondary analysis of the multicenter, randomized phase 3 CONVERT trial.
  • 509 patients (4 stage I, 82 stage II, and 423 stage III) received twice-daily (45 Gy in 30 fractions) or once-daily (66 Gy in 33 fractions) CRT and prophylactic cranial irradiation, if indicated.
  • Funding: Cancer Research UK Clinical Trials Awards and Advisory Committee and others.

Key results

  • Among stage I-II patients, 40.7% received twice-daily radiotherapy (RT) and 59.3% received once-daily treatment; OS was similar between arms (P=.38).
  • Median OS was 50 months in stage I-II disease and 25 months in stage III disease (HRmortality, 0.60; P=.001).
  • Compared with stage III disease, patients with stage II SCLC experienced:
    • Better 2-year OS (64% vs 51%) and 5-year OS (49% vs 28%).
    • Better median local (38 vs 17 months; P=.003) and metastatic PFS (40 vs 16 months; P<.001>

Limitations

  • Small number of stage I-II patients.

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