Both surgery and definitive concurrent chemoradiotherapy boost are acceptable treatment strategies for patients with resectable stage 3A(N2) and selected stage 3B non-small cell lung cancer (NSCLC) after induction chemotherapy and concurrent chemoradiotherapy, a new study published online ahead of print in the Journal of Clinical Oncology has shown.1
A previous phase 2 study demonstrated that induction chemotherapy followed by chemoradiotherapy and surgery is efficacious in patients with stage 3A(N2) disease and certain patients with stage 3B NSCLC.
For the phase 3 study, researchers enrolled 246 patients with pathologically proven 3A(N2) and selected patients with 3B disease that were eligible for further treatment after receiving induction chemotherapy consisting of cisplatin and paclitaxel, as well as concurrent chemoradiotherapy with cisplatin and vinorelbine.
After induction, 161 patients with resectable tumors were randomly assigned to receive a chemoradiotherapy boost or to undergo surgery.
Results showed no significant difference in 5-year overall survival or 5-year progression-free survival between the 2 treatment arms.
Overall survival rates were 44% in the surgery arm and 40% in the chemoradiotherapy boost arm, and progression-free survival rates were 32% and 35%, respectively. Of the 246 patients enrolled, 34.1% were still alive at 5 years.
“The 5-year OS and PFS rates in randomly assigned patients with resectable stage III non-small cell lung cancer were excellent with both treatments,” the authors conclude.
1. Eberhardt WEE, Pöttgen C, Gauler TC, et al. Phase III study of surgery versus definitive concurrent chemoradiotherapy boost in patients with resectable stage IIIA(N2) and selected IIIB non-small-cell lung cancer after induction chemotherapy and concurrent chemoradiotherapy [published online ahead of print November 2, 2015]. J Clin Oncol. doi:10.1200/JCO.2015.62.6812.