Induction or consolidation chemotherapy for unresectable stage III non-small-cell lung cancer patients treated with concurrent chemoradiation: a randomised phase II trial GFPC – IFCT 02-01. (January 2016)

• Record Type: Journal Article
• Authors: Fournel, Pierre; Vergnenégre, Alain; Robinet, Gilles; Léna, Hervé; Gervais, Radj; Le Caer, Hervé; Souquet, Pierre-Jean; Chavaillon, Jean-Michel; Bozonnat, Marie-Cécile; Daurès, Jean-Pierre; Chouaid, Christos; Martel-Lafay, Isabelle
• Is Part Of: European journal of cancer. Volume 52(2016)
• Page Start: 181
• Page End: 187
• Publication Date: 2016-01
• Subjects: Lung cancer -- Radiotherapy -- Chemotherapy -- Therapeutics; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.10.072
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Purpose: The objective of this randomised phase II study was to evaluate the impact in terms of response and toxicities of induction or consolidation chemotherapy respectively before or after concurrent chemoradiotherapy in unresectable stage III non-small-cell lung cancer. Patients and methods: In the induction arm, patients received induction chemotherapy with cisplatin (80 mg/m 2 ) and paclitaxel (200 mg/m 2 ) on days 1 and 29 followed by a concurrent chemoradiotherapy (66 Gy in 33 fractions, cisplatin 80 mg/m 2 days 1, 29 and 57, vinorelbine 15 mg/m 2 days 1, 8, 29, 36, 57 and 64). In consolidation arm, the same concurrent chemoradiotherapy began on day 1 followed by two cycles of cisplatin and paclitaxel. Results: One hundred twenty seven patients were randomised. The intent to treat response rates in induction and consolidation arms were 58% and 56% respectively. Median survival was 19.6 months in induction arm and 16.3 months in consolidation arm and 4-year survival rates were 21% and 30% respectively. Haematologic and non-haematologic toxicities were similar in both arms, except grade 3/4 oesophagitis, more frequent in consolidation arm than in induction arm (17% versus 10%). Conclusion: Cisplatin-based chemotherapy as induction or consolidation with concurrent chemoradiotherapy can be administrated safely. Response rates were similar in both arms with a trend in favour for consolidation arm for long-term survival. Highlights: Optimal sequencing of radiotherapy and chemotherapy is not well defined for stage III NSCLC. Cisplatin-based chemotherapy as induction or consolidation of chemoradiotherapy is safe. Response rates were similar in both arms without difference in survival.