Please note, these are the actual video- recorded proceedings from the live CME event and may include the use of trade names and other raw, unedited content. Select slides from the original presentation are omitted where Research To Practice was unable to obtain permission from the publication source and/or author. Links to view the actual reference materials have been provided for your use in place of any omitted slides.
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Adjuvant Therapy of NSCLC Winter Lung Cancer Conference 2012
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Please note, these are the actual video-recorded proceedings from the live CME event and may include the
use of trade names and other raw, unedited content. Select slides from the original presentation are omitted
where Research To Practice was unable to obtain permission from the publication source and/or author. Links to view the actual reference materials have been
provided for your use in place of any omitted slides.
CT may be detrimental for stage IA, but stage IA patients were generally not given cisplatin+vinorelbine (13% of stage IA patients versus ~43% for other stages)
Test for trend: p = 0.051
CategoryNo. Deaths /No. Entered
Hazard Ratio (Chemotherapy /
Control) [95% CI]Stage IA 102 / 347 1.41 [0.96;2.09]Stage IB 509 / 1371 0.92 [0.78;1.10]Stage II 880 / 1616 0.83 [0.73;0.95]Stage III 865 / 1247 0.83 [0.73;0.95]
E1505 – Adjuvant ChemotherapyE1505 – Adjuvant ChemotherapyWakelee et al - ASCO 2011Wakelee et al - ASCO 2011
• Between Aug 2007 and Jan 2010, 557 patients were enrolled:– median age 61– 52% female– 54% adeno, 31% squamous – 23% IB, 43% II, 29% IIIA (N2) , 4% IIIA (T3N1)
Reasons for earlier termination (events)* patients (n=15) patients (n=41)• Unacceptable toxicity according to protocol** 4 19
• Unacceptable toxicity perceived by patient 6 7
• Relapse of disease 0 2
• Withdrawal of consent 0 4
• Death (therapy related) 1 (0) 2 (0)
• Non-compliance to protocol 0 2
• Medical decision by investigator 4 5
• Major protocol violation 0 1
• Other reasons 0 4
Results End of therapy
*multiple reasons possible**delay >2 weeks due to toxicity or in case of G3/4 non-hem toxicity
TREAT: Time to treatment failureTREAT: Time to treatment failure
Time from surgery to withdrawal due toTime from surgery to withdrawal due to • AEAE• progression / relapse / deathprogression / relapse / death• failure to return to therapyfailure to return to therapy• refusal of treatment / withdrawal of consent refusal of treatment / withdrawal of consent
Time to treatment failure also in favor of cisplatin/pemetrexed, p<0.001
Adjuvant Therapy of NSCLC
• Stage IB
• Chemotherapy choices– Use cisplatin whenever possible– Cis-Vnb is associated with greater toxicity
• PORT
Adjuvant Therapy of NSCLC
• Stage IB
• Chemotherapy choices
• PORT
ANITA - PORT EvaluationANITA - PORT Evaluation• PORT: 33% on obs, 22% on chemoPORT: 33% on obs, 22% on chemo• For all chemo > XRT = chemo/XRT > 0For all chemo > XRT = chemo/XRT > 0• For N2 chemo/XRT > chemo > XRT > 0For N2 chemo/XRT > chemo > XRT > 0
XRT No No Yes YesChemo No Yes No Yes
All pts MST 26mo 93mo 50mo 46mo
N2 MST 13mo 24mo 23mo 47mo
Rosell, IASLC 11, Abs Pr3, 2005
Overall survival for N2 pts stratified by Overall survival for N2 pts stratified by postoperative radiotherapy (PORT) usepostoperative radiotherapy (PORT) use
– – SEER dataSEER data
There is benefit of PORT in stage IIIA-N2 disease, and the role of PORT
in early stages of NSCLC should be clarified in ongoing phase III trials.
““Lung ART”Lung ART”P.I. Dr Cécile Le PechouxP.I. Dr Cécile Le Pechoux