Randomised study of adjuvant chemotherapy for completely resected p-stage I–IIIA non-small cell lung cancer

Abstract

We evaluated the therapeutic usefulness of adjuvant chemotherapy in patients with completely resected non-small cell lung cancer (NSCLC). We also examined the relation between DNA ploidy pattern and the response to chemotherapy. A total of 267 patients with NSCLC (pathologically documented stage I, II, or IIIA) underwent complete resection, and DNA ploidy pattern was analysed. Patients with stage I disease (n ¼ 172) were randomly assigned to receive surgery alone (group A) or surgery followed by adjuvant chemotherapy (UFT (oral anti-cancer drug, a combination of Uracil and Tegaful) 400 mg day À1 for 1 year after surgery; group B). Stage II or IIIA disease patients (n ¼ 95) were randomly assigned to surgery alone (group C) or surgery followed by chemotherapy (two 28-day courses of cisplatin 80 mg m À2 on day 1 plus vindesine 3 mg m À2 on days 1 and 8, followed by UFT 400 mg day À1 for at least 1 year; group D). Eight-year overall survival rate in patients with stage I disease was 74.2% (95% confidence interval (CI): 64.4 -84.0%) in group B and 57.6% (95% CI: 46.4 -68.8%) in group A (P ¼ 0.045 by log-rank test). In patients with stage II and IIIA disease, no difference was found between groups C and D. Analysis according to DNA ploidy pattern revealed no difference between the groups. Postoperative chemotherapy with UFT was suggested to be useful in patients with completely resected stage I NSCLC. No difference was seen in relation to DNA pattern in any treatment group.

Patient-Derived First Generation Xenografts of Non–Small Cell Lung Cancers: Promising Tools for Predicting Drug Responses for Personalized Chemotherapy

“…Such models would also have to allow testing of drugs within a short time frame (6-8 weeks) to conform with timely initiation of therapy (25)(26)(27). The first generation xenografts of primary NSCLCs used in the present study were shown to fulfill these criteria.…”

“…The subrenal capsule graft site permits high tissue perfusion and hence promotes viability and growth of the xenografts and their retention of major histopathologic and genetic characteristics of the original cancers, making them useful for drug response evaluation (22)(23)(24). In the clinic, NSCLC patients in general receive adjuvant chemotherapy 3 to 6 weeks after surgery (25)(26)(27). In view of this, the determination of drug response must be completed within this time frame.…”

UFT (Tegafur and Uracil) as Postoperative Adjuvant Chemotherapy for Solid Tumors (Carcinoma of the Lung, Stomach, Colon/Rectum, and Breast): Clinical Evidence, Mechanism of Action, and Future Direction

“…Nine RCTs of postoperative adjuvant chemotherapy with UFT alone (Table 1A) [7][8][9][27][28][29] or UFT following CDDP-based regimen (Table 1B) 7,9,[30][31][32] have been reported. The 2nd study conducted by the West Japan Study Group for Lung Cancer Surgery (WJSG) is the landmark trial showing the effi cacy of postoperative adjuvant chemotherapy for resected NSCLC.…”

Biomarkers for efficacy of adjuvant chemotherapy following complete resection in NSCLC stages I–IIIA

“…NAKAGAWA et al [59] found male sex to be associated with poorer OS (HR It is frequently observed that expression of biomarkers may vary between histological subtypes [14,15,18,22,23,25,26,51], which is another reason that the prognostic and predictive potential may vary depending on the frequencies of various histological subtypes in the study populations. Some articles in this review included several histological subtypes, while other articles focused solely on one histological subtype (tables 1-4), which needs to be kept in mind when comparing different studies on the same biomarker.…”