Pathologic Complete Response to Preoperative Chemotherapy Predicts Cure in Early-Stage Non-Small-Cell Lung Cancer: Combined Analysis of Two IFCT Randomized Trials. - Université de Franche-Comté Accéder directement au contenu
Article Dans Une Revue Journal of Thoracic Oncology Année : 2012

Pathologic Complete Response to Preoperative Chemotherapy Predicts Cure in Early-Stage Non-Small-Cell Lung Cancer: Combined Analysis of Two IFCT Randomized Trials.

Résumé

INTRODUCTION:: Our study aimed to evaluate whether pathologic complete response (pCR) in early-stage non-small-cell lung cancer (NSCLC) after neoadjuvant chemotherapy resulted in improved outcome, and to determine predictive factors for pCR. METHODS:: Eligible patients with stage-IB or -II NSCLC were included in two consecutive Intergroupe Francophone de Cancérologie Thoracique phase-III trials evaluating platinum-based neoadjuvant chemotherapy, with pCR defined by the absence of viable cancer cells in the resected surgical specimen. RESULTS:: Among the 492 patients analyzed, 41 (8.3%) achieved pCR. In the pCR group, 5-year overall survival was 80.0% compared with 55.8% in the non-pCR group (p = 0.0007). In multivariate analyses, pCR was a favorable prognostic factor of overall survival (relative risk = 0.34; 95% confidence interval = 0.18-0.64) in addition to squamous-cell carcinoma, weight loss less than or equal to 5%, and stage-IB disease. Five-year disease-free survival was 80.1% in the pCR group compared to 44.8% in the non-pCR group (p < 0.0001). Two patients (4.9%) in the pCR group experienced disease recurrence compared to 193 patients (42.8%) in the non-pCR group. SCC subtype was the only independent predictor of pCR (odds ratio [OR] = 4.30; 95% confidence interval = 1.90-9.72). CONCLUSION:: Our results showed that pCR after preoperative chemotherapy was a favorable prognostic factor in stage-IB-II NSCLC. Our study is the largest published series evaluating pCRs after preoperative chemotherapy. The only factor predictive of pCR was squamous-cell carcinoma. Identifying molecular predictive markers for pCR may help in distinguishing patients likely to benefit from neoadjuvant chemotherapy and in choosing the most adequate preoperative chemotherapy regimen.

Domaines

Cancer

Dates et versions

hal-00718849 , version 1 (18-07-2012)

Identifiants

Citer

Guillaume Mouillet, Elisabeth Monnet, Bernard Milleron, Marc Puyraveau, Elisabeth Quoix, et al.. Pathologic Complete Response to Preoperative Chemotherapy Predicts Cure in Early-Stage Non-Small-Cell Lung Cancer: Combined Analysis of Two IFCT Randomized Trials.. Journal of Thoracic Oncology, 2012, 7 (5), pp.841-849. ⟨10.1097/JTO.0b013e31824c7d92⟩. ⟨hal-00718849⟩
46 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More