Adjuvant and neoadjuvant chemotherapy in NSCLC: a paradigm shift.
The role of adjuvant chemotherapy in patients with early-stage non-small cell lung cancer (NSCLC) remained controversial for many years. Although a positive impact on overall survival was long suggested for cisplatin-based chemotherapy, early randomized clinical trials failed to confirm a clear survival benefit. Recently, the results from 4 large randomized trials, IALT, JBR.10, CALGB 9633, and ANITA indicate a significant survival benefit with adjuvant chemotherapy for patients with IB through IIIA NSCLC, and the results of these trials support the adoption of chemotherapy in addition to surgery as a new standard of care. Neoadjuvant chemotherapy is potentially better tolerated compared to post-surgical adjuvant chemotherapy, though definitive survival benefits with this approach have yet to be shown. The current status of adjuvant and neoadjuvant chemotherapy for patients with early-stage NSCLC will be discussed.
Betticher
Daniel C
DC
Clinic of Medical Oncology, Hospital of Fribourg, Fribourg, Switzerland. Betticherd@hopcantfr.ch
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D000077143:Docetaxel; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin