title: Adjuvant chemotherapy for non-small cell lung cancer.
abstract: Cisplatin must be considered the treatment standard for lung cancer chemotherapy, whatever the disease setting, at least in the Western world. After the seminal meta-analysis published in 1995, 12 randomized clinical trials (RCTs) exploring the benefits of adjuvant cisplatin-based chemotherapy have been completed, published, or presented. Although all these RCTs differ in patient features, two common suggestions emerge when the stage is taken into account: a significant benefit for chemotherapy is demonstrated for stage II and IIIA patients and none of these trials showed any significant benefit for adjuvant chemotherapy in stage IB patients. Ten years after this meta-analysis, a further individual patient data-pooled analysis exploring the eventual benefits of adjuvant cisplatin-based chemotherapy after surgery for early stage non-small cell lung cancer in the more recent RCTs has been presented. The 5-year overall survival benefit in favor of cisplatin-based chemotherapy was 5.3% (48.8% versus 43.3%, p = 0.004), with a relative risk reduction of 11%. These results confirm those reported by previous meta-analyses performed according to a literature-based approach. Advances are emerging in the selection of those patients who are likely to benefit more from such treatment. In this respect, the customized therapy based on molecular/genetic patient and disease features constitutes a new avenue to pursue.
authors: Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy. emiliobria@yahoo.it
authors: Emilio
authors: E
authors: Bria
authors: Federica
authors: F
authors: Cuppone
authors: Fabiana Letizia
authors: FL
authors: Cecere
authors: Michele
authors: M
authors: Milella
authors: Cecilia
authors: C
authors: Nisticò
authors: Francesco
authors: F
authors: Cognetti
authors: Edmondo
authors: E
authors: Terzoli
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D000970:Antineoplastic Agents; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine