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.

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.

• Authors: Junichi Soh, Shinichi Toyooka, Norihito Okumura, Hiroshige Nakamura, Masao Nakata, Motohiro Yamashita, Junichi Sakamoto, Motoi Aoe, Katsuyuki Hotta, Satoshi Morita, Hiroshi Date
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 24 Issue 11 Pg. 1367-1376 (Nov 2019) ISSN: 1437-7772 [Electronic] Japan
• PMID: 31312931 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Tegafur
• Uracil
• Carboplatin
• Paclitaxel

Topics

• Adenocarcinoma (drug therapy, mortality, pathology)
• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Carboplatin (administration & dosage)
• Carcinoma, Non-Small-Cell Lung (drug therapy, mortality, pathology)
• Carcinoma, Squamous Cell (drug therapy, mortality, pathology)
• Chemotherapy, Adjuvant
• Female
• Humans
• Lung Neoplasms (drug therapy, mortality, pathology)
• Male
• Middle Aged
• Paclitaxel (administration & dosage)
• Tegafur (administration & dosage)
• Treatment Outcome
• Uracil (administration & dosage)