2017 ASCO Annual Meeting!
Session: Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers
Type: Poster Session
Time: Saturday June 3, 8:00 AM to 11:30 AM
Location: Hall A
Survival benefit of systemic chemotherapy given as adjuvant (ACT) after thoracic surgery for N0-1 non-small cell lung cancer (NSCLC) patients (pts) with synchronous brain metastasis (SBM).
Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers
2017 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #261)
J Clin Oncol 35, 2017 (suppl; abstr 8525)
Author(s): Sarah Shin, Saikrishna S. Yendamuri, Adrienne Groman, Grace K. Dy; University at Buffalo, Buffalo, NY; Roswell Park Cancer Institute, Buffalo, NY
Background: Pts with solitary SBM and otherwise early-stage NSCLC demonstrate prolonged survival with surgical resection of both primary and metastatic disease. The role of “ACT” after thoracic surgery in this circumstance is not well-defined. We seek to determine the effect on overall survival(OS) of ACT after resection of primary tumor in pts with surgically resectable primary NSCLC and SBM. Methods: The National Cancer Database (NCDB) was queried to identify pts who underwent resection of NSCLC as the primary cancer (without other malignancies) from years 2010-2014 (n = 90,518). We then focused on pts who also were diagnosed with SBM (n = 807). Only patients with pathologically confirmed N stage 0 (n = 419) or 1 (n = 101) status were included in the final analysis. Patients who received platinum-based ACT within 3 months after surgery were considered to have received ACT. Associations between treatment groups were analyzed using the Chi-square test for categorical variables and Wilcoxon Rank Sum test for continuous variables. Univariate and multivariate proportional hazards modeling results were used to assess the effect of treatment and the confounding variables on OS. Relative prognosis was summarized using estimates and 95% confidence interval(CI) for the hazard ratio (HR). Unadjusted differences in OS between the treatments are shown using Kaplan-Meier methods. All analyses were performed using SAS version 9.4. Results: There is no imbalance in terms of gender, race, income, nodal status, histology between groups. Non-ACT pts were older (n = 181, median 64 vs 58 years in ACT group, p < 0.001). Age, nodal status, ACT, and histology were associated with OS in both univariate and multivariate analysis, with OS HR 0.51 (95% CI 0.39-0.66) in favor of ACT (n = 339). One- and 5-year survival in ACT group versus non-ACT group was 83% (95% CI 78%-87%) and 33% (25%-40%), versus 57%(95% CI 48%-65%) and 18% (95% CI 11%-26%), respectively. Conclusions: ACT after thoracic surgery for N0-1 NSCLC with SBM is associated with improved OS in this analysis.
1. Gefitinib (G) versus vinorelbine+cisplatin (VP) as adjuvant treatment in stage II-IIIA (N1-N2) non-small-cell lung cancer (NSCLC) with EGFR-activating mutation (ADJUVANT): A randomized, Phase III trial (CTONG 1104).