In patients with completely resected stage IB non-small cell lung cancer (NSCLC), adjuvant chemotherapy is associated with improved survival regardless of tumor size, a study published in the Journal of Thoracic Oncology has shown.1

Adjuvant chemotherapy improves survival in patients with completely resected stage II and III NSCLC; however, its role in those with stage IB disease remains controversial. Therefore, researchers sought to retrospectively evaluate the role of adjuvant chemotherapy in patients with resected T2N0M0 NSCLC.

For the study, investigators analyzed data from 4996 patients with pathologic stage T2N0M0 NSCLC who underwent complete resection and received adjuvant chemotherapy between 2004 and 2011. Patients were classified according to tumor size: 3.1-3.9 cm, 4-4.9 cm, 5-5.9 cm and 6-7 cm.

Results showed that adjuvant chemotherapy was associated with improved median and 5-year overall survival compared with observation for all tumor size groups.

In univariate analysis, researchers found that in patients with T2 tumors less than 4 cm, median overall survival was 101.6 months with adjuvant chemotherapy compared with 68.2 months with observation. Five-year overall survival rates were 67% and 55%, respectively (HR, 0.66; 95% CI, 0.61-0.72; P < .0001).

Similar results were observed in multivariable analysis (HR, 0.77; 95% CI, 0.70-0.83; P < .0001) and propensity match score (101.6 vs 78.9 months; 68% vs 60%; HR, 0.75; 95% CI, 0.70-0.86; P < .0001).

“The benefit in patients with tumors [less than] 4 cm strongly suggests a role for chemotherapy in this patient population and counters its current status as an exclusion criteria for adjuvant trials,” the authors conclude.

Reference

1. Morgensztern D, Du L, Waqar SN, et al. Adjuvant chemotherapy for patients with T2N0M0 non-small-cell lung cancer (NSCLC). J Thorac Oncol. doi:10.1016/j.jtho.2016.05.022.