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International Journal of Clinical Oncology

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01-11-2019 | NSCLC | Original Article

Impact of pathological stage and histological subtype on clinical outcome of adjuvant chemotherapy of paclitaxel plus carboplatin versus oral uracil–tegafur for non-small cell lung cancer: subanalysis of SLCG0401 trial

Authors: Junichi Soh, Shinichi Toyooka, Norihito Okumura, Hiroshige Nakamura, Masao Nakata, Motohiro Yamashita, Junichi Sakamoto, Motoi Aoe, Katsuyuki Hotta, Satoshi Morita, Hiroshi Date

Published in: International Journal of Clinical Oncology | Issue 11/2019

Abstract

Background

Pathological stage (pStage) and histological subtype are strong determinants of the treatment strategy for non-small cell lung cancer (NSCLC). Setouchi Lung Cancer study Group (SLCG) recently reported the results of a multicenter trial (SLCG0401) indicating that paclitaxel plus carboplatin (CBDCA/PTX) as adjuvant chemotherapy does not yield better survival than uracil–tegafur (UFT) in NSCLC patients with pStage IB–IIIA disease, while stratified analyses considering the pStage and histological subtype have not been performed.

Methods

We reanalyzed the overall survival (OS) and relapse-free survival (RFS) in 402 patients who had been randomly assigned to receive CBDCA/PTX or UFT by multivariate analysis with adjustments for the pStage and histological subtype.

Results

There were no significant differences in the OS or RFS between the two treatment settings either in the entire cohort (n = 402) and in some of subsets: pStage IB (n = 228), pStage II (n = 117), adenocarcinoma (AD, n = 265), and squamous cell carcinoma (SQ, n = 101). In pStage IIIA patients (n = 57), CBDCA/PTX yielded superior RFS to UFT [hazard ratio (HR) 0.44; P = 0.016]. Among the patients with non-AD and non-SQ histology (n = 36), UFT yielded both superior OS and RFS to CBDCA/PTX (HRs 0.16 and 0.23; P = 0.046 and 0.011, respectively).

Conclusions

There are subsets of patients in which one or the other between UFT and CBDCA/PTX is significantly more effective. Selection of adjuvant therapy for NSCLC patients needs to be made taking into consideration the pStage and histological subtype.

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Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30CrossRef

Toyooka S, Okumura N, Nakamura H et al (2018) A multicenter randomized controlled study of paclitaxel plus carboplatin versus oral uracil-tegafur as the adjuvant chemotherapy in resected non-small cell lung cancer. J Thorac Oncol 13:699–706CrossRef

Group NM-AC, Arriagada R, Auperin A et al. (2010) Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: two meta-analyses of individual patient data. Lancet 375:1267–1277.CrossRef

Keicho N, Saijo N, Shinkai T et al (1986) Phase II study of UFT in patients with advanced non-small cell lung cancer. Jpn J Clin Oncol 16:143–146CrossRef

Schiller JH, Harrington D, Belani CP et al (2002) Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 346:92–98CrossRef

Suehisa H, Toyooka S (2009) Adjuvant chemotherapy for completely resected non-small-cell lung cancer. Acta Med Okayama 63:223–230PubMed

Postmus PE, Kerr KM, Oudkerk M et al (2017) Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 28:1–21CrossRef

Wada H, Hitomi S, Teramatsu T (1996) Adjuvant chemotherapy after complete resection in non-small-cell lung cancer. West Japan study group for lung cancer surgery. J Clin Oncol 14:1048–1054CrossRef

Kato H, Ichinose Y, Ohta M et al (2004) A randomized trial of adjuvant chemotherapy with uracil–tegafur for adenocarcinoma of the lung. N Engl J Med 350:1713–1721CrossRef

10.

Hamada C, Tsuboi M, Ohta M et al (2009) Effect of postoperative adjuvant chemotherapy with tegafur-uracil on survival in patients with stage IA non-small cell lung cancer: an exploratory analysis from a meta-analysis of six randomized controlled trials. J Thorac Oncol 4:1511–1516CrossRef

11.

Novello S, Barlesi F, Califano R et al (2016) Metastatic non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 27:v1–v27CrossRef

12.

Sobin LH, Wittekind C (2002) TNM classification of malignant tumors, 6thed. Wiley, New York

13.

Sobin LH, Gospodarowicz MK, Wittekind C (2010) International union against Cancer. TNM classification of malignant tumours, Wiley-Blackwell, Hoboken

14.

Hamada C, Tanaka F, Ohta M et al (2005) Meta-analysis of postoperative adjuvant chemotherapy with tegafur-uracil in non-small-cell lung cancer. J Clin Oncol 23:4999–5006CrossRef

15.

Ebi M, Shimura T, Yamada S et al (2012) A patient with gastric adenosquamous carcinoma with intraperitoneal free cancer cells who remained recurrence-free with postoperative S-1 chemotherapy. Intern Med 51:3125–3129CrossRef

16.

Saso K, Murata M, Asai K, et al (2015) [A case of pancreatic cancer with multiple liver metastases that developed postoperatively and showed a complete response with S-1 monotherapy]. Gan Kagaku Ryoho 42:1620–1622

17.

Komatsu Y, Hama M, Shinagawa Y, et al (2012) [A case of pulmonary pleomorphic carcinoma treated with S-1 following radiotherapy]. Gan To Kagaku Ryoho 39:687–689PubMed

18.

Zhang H, Shen G, Zhang S et al (2018) Novel fluoropyrimidine-based chemotherapy for advanced well-differentiated neuroendocrine tumors: a clinical update. Expert Opin Pharmacother 19:795–807CrossRef

19.

Paz-Ares L, Luft A, Vicente D et al (2018) Pembrolizumab plus chemotherapy for squamous non–small-cell lung cancer. New Engl J Med 379:2040–2051CrossRef

20.

Antonia SJ, Villegas A, Daniel D et al (2018) Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 379:2342–2350CrossRef

21.

Yan Y, Kumar AB, Finnes H et al (2018) Combining immune checkpoint inhibitors with conventional cancer therapy. Front Immunol 9:1739CrossRef

22.

Toews ML, Bylund DB (2005) Pharmacologic principles for combination therapy. Proc Am Thorac Soc 2:282–289 (discussion 290–281)CrossRef

Title: Impact of pathological stage and histological subtype on clinical outcome of adjuvant chemotherapy of paclitaxel plus carboplatin versus oral uracil–tegafur for non-small cell lung cancer: subanalysis of SLCG0401 trial
Authors: Junichi Soh
Shinichi Toyooka
Norihito Okumura
Hiroshige Nakamura
Masao Nakata
Motohiro Yamashita
Junichi Sakamoto
Motoi Aoe
Katsuyuki Hotta
Satoshi Morita
Hiroshi Date
Publication date: 01-11-2019
Publisher: Springer Singapore
Keywords: NSCLC
NSCLC
Cytostatic Therapy
Published in: International Journal of Clinical Oncology / Issue 11/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-019-01508-9

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Abstract

Background

Methods

Results

Conclusions

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