Top

International Journal of Clinical Oncology

Published in:

01-04-2017 | Review Article

The effect of consolidation chemotherapy after concurrent chemoradiotherapy on the survival of patients with locally advanced non-small cell lung cancer: a meta-analysis

Published in: International Journal of Clinical Oncology | Issue 2/2017

Abstract

Whether consolidation chemotherapy (CCT) after chemoradiotherapy (CRT) helps in the treatment of locally advanced non-small cell lung cancer (LA-NSCLC) is controversial. The aim of this meta-analysis was to evaluate the impact of CCT on overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and toxicities in patients with inoperable LA-NSCLC. PubMed, Embase, The Cochrane Library, WanFang, VIP, and CNKI were searched to identify any relevant publications. After screening the literature and completing quality assessment and data extraction, the meta-analysis was performed using RevMan5.3 software. Ultimately, 5 eligible studies with a total of 1036 patients were selected for the present meta-analysis. The results of the analysis indicated that treatment of LA-NSCLC patients with CRT followed by CCT improved OS (pooled HR 0.85; 95% CI 0.73–0.99; P = 0.03), but did not improve PFS (pooled HR 0.78; 95% CI 0.60–1.02; P = 0.07) and ORR (P = 0.26). Although it could increase the risk of grade ≥3 infection (P = 0.04), it may not increase the risk of grade ≥3 radiation pneumonitis (P = 0.09) during the CCT period. CCT after concurrent CRT may provide additional benefits in the treatment of LA-NSCLC. Although this therapeutic strategy did not prolong PFS, further assessment is warranted.

Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefPubMed

Molina JR, Yang P, Cassivi SD et al (2008) Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc 83:584–594CrossRefPubMedPubMedCentral

Furuse K, Fukuoka M, Kawahara M et al (1999) Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol 17:2692–2699CrossRefPubMed

Aupérin A, Le Péchoux C, Rolland E et al (2010) Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol 28:2181–2190CrossRefPubMed

Curran WJ Jr, Paulus R, Langer CJ et al (2011) Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst 103:1452–1460CrossRefPubMedPubMedCentral

Ramnath N, Dilling TJ, Harris LJ et al (2013) Treatment of stage III non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143(Suppl):e314S–e3140SCrossRefPubMed

Soon YY, Stockler MR, Askie LM et al (2009) Duration of chemotherapy for advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized trials. J Clin Oncol 27:3277–3283CrossRefPubMed

Zhang X, Zang J, Xu J et al (2011) Maintenance therapy with continuous or switch strategy in advanced non-small cell lung cancer: a systematic review and meta-analysis. Chest 140:117–126CrossRefPubMed

Cortesi E, Moscetti L, Nelli F et al (2007) Induction therapy with paclitaxel and carboplatin followed by hyperfactionated radiotherapy plus weekly concurrent chemotherapy and subsequent consolidation therapy in unresectable locally advanced non-small-cell lung cancer. Tumori 93:133–137PubMed

10.

Tsujino K, Kurata T, Yamamoto S et al (2013) Is consolidation chemotherapy after concurrent chemo-radiotherapy beneficial for patients with locally advanced non-small-cell lung cancer? A pooled analysis of the literature. J Thorac Oncol 8:1181–1189CrossRefPubMed

11.

Hanna N, Neubauer M, Yiannoutsos C et al (2008) Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: The Hoosier Oncology Group and US Oncology. J Clin Oncol 26:5755–5760CrossRefPubMed

12.

Davies AM, Chansky K, Lau DH et al (2006) Phase II study of consolidation paclitaxel after concurrent chemoradiation in poor-risk stage III non-small-cell lung cancer: SWOG S9712. J Clin Oncol 20;24(33):5242–5246

13.

Yamamoto N, Goto K, Nishio M et al (2016) Erratum to: Final overall survival in JO22903, a phase II, open-label study of first-line erlotinib for Japanese patients with EGFR, mutation-positive non-small-cell lung cancer. Int J Clin Oncol 1–9

14.

Parmar MK, Torri V, Stewart L (1998) Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med 17(24):2815–2834CrossRefPubMed

15.

Williamson PR, Smith CT, Hutton JL et al (2002) Aggregate data meta-analysis with time-to-event outcomes. Stat Med 21(22):3337–3351CrossRefPubMed

16.

Tierney JF, Stewart LA, Ghersi D et al (2007) Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 8(1):16CrossRefPubMedPubMedCentral

17.

Mutlu H, Arslan D, Gündüz Ş et al (2014) The optimal treatment modality in patients with T4N2M0 non-small cell lung cancer: the best choice may be definitive chemoradiotherapy followed by consolidation chemotherapy. Chemotherapy 60:107–111CrossRefPubMed

18.

Ahn JS, Ahn YC, Kim JH et al. Multinational randomized phase III trial with or without consolidation chemotherapy using docetaxel and cisplatin after concurrent chemoradiation in inoperable stage III non-small-cell lung cancer: KCSG-LU05-0414. J Clin Oncol 2015; 33:2660–2666

19.

Liu L, Bi N, Ji Z et al (2015) Consolidation chemotherapy may improve survival for patients with locally advanced non-small-cell lung cancer receiving concurrent chemoradiotherapy—retrospective analysis of 203 cases. BMC Cancer 15:715CrossRefPubMedPubMedCentral

20.

Jalal SI, Riggs HD, Melnyk A et al (2012) Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann Oncol 23:1730–1738CrossRefPubMed

21.

Jett JR, Scott WJ, Rivera MP et al (2003) Guidelines on treatment of stage IIIB non-small cell lung cancer. Chest 123:221S–225SCrossRefPubMed

22.

23.

Fournel P, Robinet G, Thomas P et al (2005) Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Etienned’Oncologie Thoracique-Groupe Francais de Pneumo-Cancerologie NPC 95-01 Study. J Clin Oncol 23:5910–5917CrossRefPubMed

24.

Decker RH, Lynch TJ (2012) Unmet challenges in the use of novel agents in locally advanced non-small-cell lung cancer. J Clin Oncol 30:582–584CrossRefPubMed

25.

Bastos BR, Hatoum GF, Walker GR et al (2010) Efficacy and toxicity of chemoradiotherapy with carboplatin and irinotecan followed by consolidation docetaxel for unresectable stage III non-small cell lung cancer. J Thorac Oncol 5:533–539CrossRefPubMed

26.

Eroglu C, Orhan O, Unal D, et al. Concomitant chemoradiotherapy with docetaxel and cisplatin followed by consolidation chemotherapy in locally advanced unresectable non-small cell lung cancer. Ann Thorac Med 201;8(2): 109, 3

27.

Gandara DR, Chansky K, Albain KS et al (2006) Long-term survival with concurrent chemoradiation therapy followed by consolidation docetaxel in stage IIIB non-small-cell lung cancer: a phase II Southwest Oncology Group study (S9504). Clin Lung Cancer 8(2):116–121CrossRefPubMed

28.

Albain KS, Crowley JJ, Turrisi AT et al (2002) Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer: a Southwest Oncology Group phase II study, SWOG 9019. J Clin Oncol 20(16):3454–3460CrossRefPubMed

29.

Horinouchi H, Sekine I, Sumi M et al (2013) Long-term results of concurrent chemoradiotherapy using cisplatin and vinorelbine for stage III non-small-cell lung cancer. Cancer Sci 104:93–97CrossRefPubMed

30.

Takigawa N, Kiura K, Segawa Y et al (2006) Second primary cancer in survivors following concurrent chemoradiation for locally advanced non-small-cell lung cancer. Br J Cancer 95:1142–1144CrossRefPubMedPubMedCentral

Title: The effect of consolidation chemotherapy after concurrent chemoradiotherapy on the survival of patients with locally advanced non-small cell lung cancer: a meta-analysis
Publication date: 01-04-2017
Published in: International Journal of Clinical Oncology / Issue 2/2017
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-1074-x

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2017

Acute and late toxicities of pirarubicin in the treatment of childhood acute lymphoblastic leukemia: results from a clinical trial by the Japan Association of Childhood Leukemia Study

Feasibility of adjuvant chemotherapy with S-1 plus carboplatin followed by single-agent maintenance therapy with S-1 for completely resected non-small-cell lung cancer: results of the Setouchi Lung Cancer Group Study 1001

Biphasic decline in renal function after radical cystectomy with urinary diversion

Association between UGT1A1*28*28 genotype and lung cancer in the Japanese population

Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis

Multi-institutional phase II study on the feasibility of liver resection following preoperative mFOLFOX6 therapy for resectable liver metastases from colorectal cancers

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Association between UGT1A12828 genotype and lung cancer in the Japanese population