Adjuvant therapy extends survival in early SCLC

Surgical resection followed by adjuvant chemotherapy, with or without prophylactic cranial irradiation, extends overall survival beyond that achieved with surgery alone in early-stage small-cell lung cancer, according to a report published online Jan. 18 in Journal of Clinical Oncology.

National Comprehensive Cancer Network guidelines recommend surgery with adjuvant chemotherapy for patients with stage I SCLC, and also recommend prophylactic cranial irradiation. But these recommendations are based on “limited” data, and the roles of both adjuvant chemotherapy and irradiation for this patient population are “not yet well characterized,” said Dr. Chi-Fu Jeffrey Yang of Duke University Medical Center, Durham, N.C., and his associates.

©Sebastian Kaulitzki/Thinkstock

In what they described as the first population-based study to assess adjuvant therapy in such patients, the investigators analyzed information in the National Cancer Database concerning 954 patients treated across the country during 2003-2011. A total of 566 patients (59.3%) received adjuvant chemotherapy and the remaining 388 did not. A total of 190 patients who received adjuvant chemotherapy also had prophylactic radiotherapy to the brain (99 patients), the lung (87 patients), or to an unrecorded site (4 patients).

The median follow-up for the entire cohort was 43 months. Overall median survival time was 55.6 months, and 5-year survival was 47.4%.

Compared with no adjuvant therapy, treatment with adjuvant chemotherapy, with or without radiotherapy, significantly extended both overall survival (66.0 months vs 42.1 months) and the 5-year overall survival rate (52.7% vs 40.4%) in the primary analysis of the study. After the data were adjusted to account for multiple confounding variables, the use of adjuvant chemotherapy alone and of adjuvant chemotherapy plus radiotherapy both were associated with improved survival, Dr. Yang and his associates said (J Clin Oncol. 2016 Jan. 18. doi:10.1200/jco.2015.63.8171).

In contrast, adjuvant chemotherapy with thoracic irradiation and thoracic irradiation alone were not associated with improved survival. However, it is possible that this study was affected by selection bias in that patients who received both chemotherapy and cranial irradiation may have been healthier than those who did not. The researchers attempted to control for possible bias in the multivariable analysis, but further assessment in prospective randomized clinical trials is warranted, they added.

Surgical resection followed by adjuvant chemotherapy, with or without prophylactic cranial irradiation, extends overall survival beyond that achieved with surgery alone in early-stage small-cell lung cancer, according to a report published online Jan. 18 in Journal of Clinical Oncology.

National Comprehensive Cancer Network guidelines recommend surgery with adjuvant chemotherapy for patients with stage I SCLC, and also recommend prophylactic cranial irradiation. But these recommendations are based on “limited” data, and the roles of both adjuvant chemotherapy and irradiation for this patient population are “not yet well characterized,” said Dr. Chi-Fu Jeffrey Yang of Duke University Medical Center, Durham, N.C., and his associates.

©Sebastian Kaulitzki/Thinkstock

In what they described as the first population-based study to assess adjuvant therapy in such patients, the investigators analyzed information in the National Cancer Database concerning 954 patients treated across the country during 2003-2011. A total of 566 patients (59.3%) received adjuvant chemotherapy and the remaining 388 did not. A total of 190 patients who received adjuvant chemotherapy also had prophylactic radiotherapy to the brain (99 patients), the lung (87 patients), or to an unrecorded site (4 patients).

The median follow-up for the entire cohort was 43 months. Overall median survival time was 55.6 months, and 5-year survival was 47.4%.

Compared with no adjuvant therapy, treatment with adjuvant chemotherapy, with or without radiotherapy, significantly extended both overall survival (66.0 months vs 42.1 months) and the 5-year overall survival rate (52.7% vs 40.4%) in the primary analysis of the study. After the data were adjusted to account for multiple confounding variables, the use of adjuvant chemotherapy alone and of adjuvant chemotherapy plus radiotherapy both were associated with improved survival, Dr. Yang and his associates said (J Clin Oncol. 2016 Jan. 18. doi:10.1200/jco.2015.63.8171).

In contrast, adjuvant chemotherapy with thoracic irradiation and thoracic irradiation alone were not associated with improved survival. However, it is possible that this study was affected by selection bias in that patients who received both chemotherapy and cranial irradiation may have been healthier than those who did not. The researchers attempted to control for possible bias in the multivariable analysis, but further assessment in prospective randomized clinical trials is warranted, they added.

Surgical resection followed by adjuvant chemotherapy, with or without prophylactic cranial irradiation, extends overall survival beyond that achieved with surgery alone in early-stage small-cell lung cancer, according to a report published online Jan. 18 in Journal of Clinical Oncology.

National Comprehensive Cancer Network guidelines recommend surgery with adjuvant chemotherapy for patients with stage I SCLC, and also recommend prophylactic cranial irradiation. But these recommendations are based on “limited” data, and the roles of both adjuvant chemotherapy and irradiation for this patient population are “not yet well characterized,” said Dr. Chi-Fu Jeffrey Yang of Duke University Medical Center, Durham, N.C., and his associates.

©Sebastian Kaulitzki/Thinkstock

In what they described as the first population-based study to assess adjuvant therapy in such patients, the investigators analyzed information in the National Cancer Database concerning 954 patients treated across the country during 2003-2011. A total of 566 patients (59.3%) received adjuvant chemotherapy and the remaining 388 did not. A total of 190 patients who received adjuvant chemotherapy also had prophylactic radiotherapy to the brain (99 patients), the lung (87 patients), or to an unrecorded site (4 patients).

The median follow-up for the entire cohort was 43 months. Overall median survival time was 55.6 months, and 5-year survival was 47.4%.

Compared with no adjuvant therapy, treatment with adjuvant chemotherapy, with or without radiotherapy, significantly extended both overall survival (66.0 months vs 42.1 months) and the 5-year overall survival rate (52.7% vs 40.4%) in the primary analysis of the study. After the data were adjusted to account for multiple confounding variables, the use of adjuvant chemotherapy alone and of adjuvant chemotherapy plus radiotherapy both were associated with improved survival, Dr. Yang and his associates said (J Clin Oncol. 2016 Jan. 18. doi:10.1200/jco.2015.63.8171).

In contrast, adjuvant chemotherapy with thoracic irradiation and thoracic irradiation alone were not associated with improved survival. However, it is possible that this study was affected by selection bias in that patients who received both chemotherapy and cranial irradiation may have been healthier than those who did not. The researchers attempted to control for possible bias in the multivariable analysis, but further assessment in prospective randomized clinical trials is warranted, they added.