Neoadjuvant Chemotherapy in Stage III NSCLC

Editor:
Kerrin G. Robinson Medical/Scientific Editor, Journal of the National Comprehensive Cancer Network

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Authors:
Jeffrey Allen From the University of Tennessee Cancer Institute, Memphis, Tennessee.

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and
Mohammad Jahanzeb From the University of Tennessee Cancer Institute, Memphis, Tennessee.

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Volume/Issue:
Volume 6: Issue 3
Online Publication Date:
Mar 2008
DOI:
https://doi.org/10.6004/jnccn.2008.0024
Full access

Non-small cell lung cancer (NSCLC) continues to be the leading cause of cancer-related mortality in the United States. Current standard care for treating NSCLC is surgical resection, when feasible, followed by adjuvant chemotherapy in stages II and III. Neoadjuvant or induction chemotherapy may have several potential advantages compared with adjuvant chemotherapy and has been evaluated in randomized and nonrandomized clinical trials in NSCLC. This article reviews the data for neoadjuvant chemotherapy in NSCLC with a particular focus on regionally advanced disease (stage III) that is still amenable to surgical resection.

Correspondence: Mohammad Jahanzeb, MD, University of Tennessee Cancer Institute, 1331 Union Avenue, Memphis, TN 38104. E-mail: mj@tennessee.edu

Disclosure: Kerrin G. Robinson, MA, has disclosed no relevant financial relationships.

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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
  • 1.

    Jemal A, Siegel R, Ward E et al.. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66.

  • 2.

    Huxley R, Jamrozik K, Lam TH et al.. Impact of smoking and smoking cessation on lung cancer mortality in the Asia-Pacific region. Am J Epidemiol 2007;165:1280–1286.

  • 3.

    Andre F, Grunenwald D, Pignon JP et al.. Survival of patients with resected N2 non-small-cell lung cancer: evidence for a subclassification and implications. J Clin Oncol 2000;18:2981–2989.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Martini N, Flehinger BJ, Zaman MB, Beattie EJ Jr et al.. Results of resection in non-oat cell carcinoma of the lung with mediastinal lymph node metastases. Ann Surg 1983;198:386–397.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small Cell Lung Cancer Collaborative Group. BMJ 1995;311:899–909.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Arriagada R, Bergman B, Dunant A et al.. Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med 2004;350:351–360.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Douillard JY, Rosell R, De Lena M et al.. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol 2006;7:719–727.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Scagliotti GV. The ALPI Trial: the Italian/European experience with adjuvant chemotherapy in resectable non-small lung cancer. Clin Cancer Res 2005;11(13 Pt 2):5011s–5016s.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Waller D, Peake MD, Stephens RJ et al.. Chemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial. Eur J Cardiothorac Surg 2004;26:173–182.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Winton T, Livingston R, Johnson D et al.. Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 2005;352:2589–2597.

  • 11.

    Martini N, Kris MG, Flehinger BJ et al.. Preoperative chemotherapy for stage IIIa (N2) lung cancer: the Sloan-Kettering experience with 136 patients. Ann Thorac Surg 1993;55:1365–1373; discussion 1373–1374.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Ng KK, Kris MG, Ginsberg RJ et al.. Induction chemotherapy employing dose-intense cisplatin with mitomycin and vinblastine (MVP400), followed by thoracic surgery or irradiation, for patients with stage III nonsmall cell lung carcinoma. Cancer 1999;86:1189–1197.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Pisters KM, Ginsberg RJ, Giroux DJ et al.. Induction chemotherapy before surgery for early-stage lung cancer: a novel approach. Bimodality Lung Oncology Team. J Thorac Cardiovasc Surg 2000;119:429–439.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Lorent N, De Leyn P, Lievens Y et al.. Long-term survival of surgically staged IIIA-N2 non-small-cell lung cancer treated with surgical combined modality approach: analysis of a 7-year prospective experience. Ann Oncol 2004;15:1645–1653.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Betticher DC, Hsu Schmitz SF, Totsch M et al.. Mediastinal lymph node clearance after docetaxel-cisplatin neoadjuvant chemotherapy is prognostic of survival in patients with stage IIIA pN2 non-small-cell lung cancer: a multicenter phase II trial. J Clin Oncol 2003;21:1752–1759.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Jaklitsch MT, Herndon JE II, DeCamp MM Jr et al.. Nodal down-staging predicts survival following induction chemotherapy for stage IIIA (N2) non-small cell lung cancer in CALGB protocol #8935. J Surg Oncol 2006;94:599–606.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Bueno R, Richards WG, Swanson SJ et al.. Nodal stage after induction therapy for stage IIIA lung cancer determines patient survival. Ann Thorac Surg 2000;70:1826–1831.

  • 18.

    Van Zandwijk N, Smit EF, Kramer GW et al.. Gemcitabine and cisplatin as induction regimen for patients with biopsy-proven stage IIIA N2 non-small-cell lung cancer: a phase II study of the European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group (EORTC 08955). J Clin Oncol 2000;18:2658–2664.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Migliorino MR, De Marinis F, Nelli F et al.. A 3-week schedule of gemcitabine plus cisplatin as induction chemotherapy for stage III non-small cell lung cancer. Lung Cancer 2002;35:319–327.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    De Marinis F, Nelli F, Migliorino MR et al.. Gemcitabine, paclitaxel, and cisplatin as induction chemotherapy for patients with biopsy-proven stage IIIA(N2) nonsmall cell lung carcinoma: a phase II multicenter study. Cancer 2003;98:1707–1715.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Roth JA, Fossella F, Komaki R et al.. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. J Natl Cancer Inst 1994;86:673–680.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Rosell R, Gomez-Codina J, Camps C et al.. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer. N Engl J Med 1994;330:153–158.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Roth JA, Atkinson EN, Fossella F et al.. Long-term follow-up of patients enrolled in a randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. Lung Cancer 1998;21:1–6.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Rosell R, Gomez-Codina J, Camps C et al.. Preresectional chemotherapy in stage IIIA non-small-cell lung cancer: a 7-year assessment of a randomized controlled trial. Lung Cancer 1999;26:7–14.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Depierre A, Milleron B, Moro-Sibilot D et al.. Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1N0), II, and IIIa non-small-cell lung cancer. J Clin Oncol 2002;20:247–253.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Gilligan D, Nicolson M, Smith I et al.. Preoperative chemotherapy in patients with resectable non-small cell lung cancer: results of the MRC LU22/NVALT 2/EORTC 08012 multicentre randomised trial and update of systematic review. Lancet 2007;369:1929–1937.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Dautzenberg B, Benichou J, Allard P et al.. Failure of the perioperative PCV neoadjuvant polychemotherapy in resectable bronchogenic non-small cell carcinoma. Results from a randomized phase II trial. Cancer 1990;65:2435–2441.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Nagai K, Tsuchiya R, Mori T et al.. A randomized trial comparing induction chemotherapy followed by surgery with surgery alone for patients with stage IIIA N2 non-small cell lung cancer (JCOG 9209). J Thorac Cardiovasc Surg 2003;125:254–260.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Pisters KM, Vallieres E, Bunn P et al.. S9900: surgery alone or surgery plus induction (ind) paclitaxel/carboplatin (PC) chemotherapy in early stage non-small cell lung cancer (NSCLC): follow-up on a phase III trial [abstract]. J Clin Oncol 2007;25(Suppl 1):7520.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Sorensen JB, Riska H, Ravn J et al.. Scandinavian phase III trial of neoadjuvant chemotherapy in NSCLC stages IB-IIIA/T3 [abstract]. J Clin Oncol 2005;23(Suppl 1):7146.

  • 31.

    Pisters KM, Vallieres E, Bunn P et al.. S9900: a phase III trial of surgery alone or surgery plus preoperative (preop) paclitaxel/carboplatin (PC) chemotherapy in early stage non-small cell lung cancer (NSCLC): preliminary results [abstract]. J Clin Oncol 2005;23(Suppl 1):7012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Berghmans T, Paesmans M, Meert AP et al.. Survival improvement in resectable non-small cell lung cancer with (neo)adjuvant chemotherapy: results of a meta-analysis of the literature. Lung Cancer 2005;49:13–23.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Burdett S, Stewart LA, Rydzewska L. A systematic review and meta-analysis of the literature: chemotherapy and surgery versus surgery alone in non-small cell lung cancer. J Thorac Oncol 2006;1:611–621.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Pass HI, Pogrebniak HW, Steinberg SM et al.. Randomized trial of neoadjuvant therapy for lung cancer: interim analysis. Ann Thorac Surg 1992;53:992–998.

  • 35.

    Mattson KV, Abratt RP, ten Velde G, Krofta K. Docetaxel as neoadjuvant therapy for radically treatable stage III non-small-cell lung cancer: a multinational randomised phase III study. Ann Oncol 2003;14:116–122.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Pignon JP, Tribodet H, Scagliotti GV et al.. Lung Adjuvant Cisplatin Evaluation (LACE): a pooled analysis of five randomized clinical trials including 4,584 patients [abstract]. J Clin Oncol 2006;24(Suppl 1):7008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Bria E, Gralla RJ, Raftopoulos G et al.. Does adjuvant chemotherapy improve survival in non small cell lung cancer (NSCLC)? A pooled-analysis of 6494 patients in 12 studies, examining survival and magnitude of benefit [abstract]. J Clin Oncol 2005;23(Suppl 1):7140.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Siegenthaler MP, Pisters KM, Merriman KW et al.. Preoperative chemotherapy for lung cancer does not increase surgical morbidity. Ann Thorac Surg 2001;71:1105–1111; discussion 1111–1112.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Rosell R, Felip E, Taron M et al.. Gene expression as a predictive marker of outcome in stage IIB-IIIA-IIIB non-small cell lung cancer after induction gemcitabine-based chemotherapy followed by resectional surgery. Clin Cancer Res 2004;10(12 Pt 2):4215s–4219s.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Isla D, Sarries C, Rosell R et al.. Single nucleotide polymorphisms and outcome in docetaxel-cisplatin-treated advanced non-small-cell lung cancer. Ann Oncol, 2004;15:1194–1203.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Ceppi P, Volante M, Novello S et al.. ERCC1 and RRM1 gene expressions but not EGFR are predictive of shorter survival in advanced non-small-cell lung cancer treated with cisplatin and gemcitabine. Ann Oncol 2006;17:1818–1825.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Cerfolio RJ, Bryant AS, Ojha B. Restaging patients with N2 (stage IIIa) non-small cell lung cancer after neoadjuvant chemoradiotherapy: a prospective study. J Thorac Cardiovasc Surg 2006;131:1229–1235.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    De Waele M, Hendricks J, Lauwers P et al.. Nodal status at repeat mediastinoscopy determines survival in non-small cell lung cancer with mediastinal nodal involvement, treated by induction therapy. Eur J Cardiothorac Surg 2006;29:240–243.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Mateu-Navarro M, Rami-Porta R, Bastus-Piulats R et al.. Remediastinoscopy after induction chemotherapy in non-small cell lung cancer. Ann Thorac Surg 2000;70:391–395.

  • 45.

    Van Schil P, van der Schoot J, Poniewierski J et al.. Remediastinoscopy after neoadjuvant therapy for non-small cell lung cancer. Lung Cancer 2002;37:281–285.

  • 46.

    De Leyn P, Stroobants S, De Wever W et al.. Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 non-small-cell lung cancer: a Leuven Lung Cancer Group Study. J Clin Oncol 2006;24:3333–3339.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Annema JT, Veselic M, Versteegh MI et al.. Mediastinal restaging: EUS-FNA offers a new perspective. Lung Cancer 2003;42:311–318.

Copyright:
Copyright © 2008 by the National Comprehensive Cancer Network
Page Numbers:
9
Article Category:
Research Article
Received:
05 Oct 2007
Accepted:
21 Dec 2007
Print Publication Date:
01 Mar 2008
Online Publication Date:
Mar 2008
Keywords:
Neoadjuvant chemotherapy; non–small cell lung cancer; review

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