ASCO: Meta-Analysis Backs Benefits of Adjuvant Chemotherapy for NSCLC

CHICAGO, June 6 -- An updated and expanded meta-analysis has reinforced the survival advantage conferred by adjuvant chemotherapy in non-small-cell lung cancer, first hinted at 12 years ago.

Patients receiving adjuvant chemotherapy had a statistically significant 13% reduction in the relative risk of death at five years, and a 4% absolute reduction, compared with patients treated with surgery alone (P

The analysis revealed no clear evidence of a variable effect of chemotherapy across the trials. The data suggested a difference in benefit according to the chemotherapy regimen used, but the finding was driven in large part by one small (83 patients) negative study that had an extreme result compared to other trials, said Dr. Stewart. The apparent outlier effect was confirmed by a sensitivity analysis that excluded the trial.

Subgroup analysis demonstrated a robust impact of chemotherapy. Chemotherapy benefited older and younger patients, men and women, patients with adenocarcinoma or squamous histology, and three of four cancer stages (the exception being stage IIIb-IV, which accounted for ~1% of the patients).

Analysis of chemotherapy's effect by stage showed that patients with stage I disease benefited from platinum-based and tegafur/UFT-based regimens. The finding warrants further exploration, said Dr. Stewart, who cautioned that the analysis by stage was exploratory and not a pre-specified evaluation.