Lung adjuvant cisplatin evaluation: A pooled analysis by the LACE collaborative group

Jean Pierre Pignon, Hélène Tribodet, Giorgio V. Scagliotti, Jean Yves Douillard, Frances A. Shepherd, Richard J. Stephens, Ariane Dunant, Valter Torri, Rafael Rosell, Lesley Seymour, Stephen G. Spiro, Estelle Rolland, Roldano Fossati, Delphine Aubert, Keyue Ding, David Waller, Thierry Le Chevalier

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Abstract

Purpose: Several recent trials have shown a significant overall survival (OS) benefit from postoperative cisplatin-based chemotherapy in patients with non-small-cell lung cancer (NSCLC). The aim of the Lung Adjuvant Cisplatin Evaluation was to identify treatment options associated with a higher benefit or groups of patients who particularly benefit from postoperative chemotherapy. Patients and Methods: Individual patient data were collected and pooled from the five largest trials (4,584 patients) of cisplatin-based chemotherapy in completely resected patients that were conducted after the 1995 NSCLC meta-analysis. The interactions between patient subgroups or treatment types and chemotherapy effect on OS were analyzed using hazard ratios (HRs) and log-rank tests stratified by trial. Results: With a median follow-up time of 5.2 years, the overall HR of death was 0.89 (95% CI, 0.82 to 0.96; P = .005), corresponding to a 5-year absolute benefit of 5.4% from chemotherapy. There was no heterogeneity of chemotherapy effect among trials. The benefit varied with stage (test for trend, P = .04; HR for stage IA = 1.40; 95% CI, 0.95 to 2.06; HR for stage IB = 0.93; 95% CI, 0.78 to 1.10; HR for stage II = 0.83; 95% CI, 0.73 to 0.95; and HR for stage III = 0.83; 95% CI, 0.72 to 0.94). The effect of chemotherapy did not vary significantly (test for interaction, P = .11) with the associated drugs, including vinorelbine (HR = 0.80; 95% CI, 0.70 to 0.91), etoposide or vinca alkaloid (HR = 0.92; 95% CI, 0.80 to 1.07), or other (HR = 0.97; 95% CI, 0.84 to 1.13). Chemotherapy effect was higher in patients with better performance status. There was no interaction between chemotherapy effect and sex, age, histology, type of surgery, planned radiotherapy, or planned total dose of cisplatin. Conclusion: Postoperative cisplatin-based chemotherapy significantly improves survival in patients with NSCLC.

Original languageEnglish
Pages (from-to)3552-3559
Number of pages8
JournalJournal of Clinical Oncology
Volume26
Issue number21
DOIs
Publication statusPublished - 2008

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Cisplatin
Drug Therapy
Lung
Non-Small Cell Lung Carcinoma
Survival
Vinca Alkaloids
Etoposide
Meta-Analysis
Histology
Radiotherapy
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Pignon, J. P., Tribodet, H., Scagliotti, G. V., Douillard, J. Y., Shepherd, F. A., Stephens, R. J., ... Le Chevalier, T. (2008). Lung adjuvant cisplatin evaluation: A pooled analysis by the LACE collaborative group. Journal of Clinical Oncology, 26(21), 3552-3559. https://doi.org/10.1200/JCO.2007.13.9030

Lung adjuvant cisplatin evaluation : A pooled analysis by the LACE collaborative group. / Pignon, Jean Pierre; Tribodet, Hélène; Scagliotti, Giorgio V.; Douillard, Jean Yves; Shepherd, Frances A.; Stephens, Richard J.; Dunant, Ariane; Torri, Valter; Rosell, Rafael; Seymour, Lesley; Spiro, Stephen G.; Rolland, Estelle; Fossati, Roldano; Aubert, Delphine; Ding, Keyue; Waller, David; Le Chevalier, Thierry.

In: Journal of Clinical Oncology, Vol. 26, No. 21, 2008, p. 3552-3559.

Research output: Contribution to journalArticle

Pignon, JP, Tribodet, H, Scagliotti, GV, Douillard, JY, Shepherd, FA, Stephens, RJ, Dunant, A, Torri, V, Rosell, R, Seymour, L, Spiro, SG, Rolland, E, Fossati, R, Aubert, D, Ding, K, Waller, D & Le Chevalier, T 2008, 'Lung adjuvant cisplatin evaluation: A pooled analysis by the LACE collaborative group', Journal of Clinical Oncology, vol. 26, no. 21, pp. 3552-3559. https://doi.org/10.1200/JCO.2007.13.9030
Pignon JP, Tribodet H, Scagliotti GV, Douillard JY, Shepherd FA, Stephens RJ et al. Lung adjuvant cisplatin evaluation: A pooled analysis by the LACE collaborative group. Journal of Clinical Oncology. 2008;26(21):3552-3559. https://doi.org/10.1200/JCO.2007.13.9030
Pignon, Jean Pierre ; Tribodet, Hélène ; Scagliotti, Giorgio V. ; Douillard, Jean Yves ; Shepherd, Frances A. ; Stephens, Richard J. ; Dunant, Ariane ; Torri, Valter ; Rosell, Rafael ; Seymour, Lesley ; Spiro, Stephen G. ; Rolland, Estelle ; Fossati, Roldano ; Aubert, Delphine ; Ding, Keyue ; Waller, David ; Le Chevalier, Thierry. / Lung adjuvant cisplatin evaluation : A pooled analysis by the LACE collaborative group. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 21. pp. 3552-3559.
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abstract = "Purpose: Several recent trials have shown a significant overall survival (OS) benefit from postoperative cisplatin-based chemotherapy in patients with non-small-cell lung cancer (NSCLC). The aim of the Lung Adjuvant Cisplatin Evaluation was to identify treatment options associated with a higher benefit or groups of patients who particularly benefit from postoperative chemotherapy. Patients and Methods: Individual patient data were collected and pooled from the five largest trials (4,584 patients) of cisplatin-based chemotherapy in completely resected patients that were conducted after the 1995 NSCLC meta-analysis. The interactions between patient subgroups or treatment types and chemotherapy effect on OS were analyzed using hazard ratios (HRs) and log-rank tests stratified by trial. Results: With a median follow-up time of 5.2 years, the overall HR of death was 0.89 (95{\%} CI, 0.82 to 0.96; P = .005), corresponding to a 5-year absolute benefit of 5.4{\%} from chemotherapy. There was no heterogeneity of chemotherapy effect among trials. The benefit varied with stage (test for trend, P = .04; HR for stage IA = 1.40; 95{\%} CI, 0.95 to 2.06; HR for stage IB = 0.93; 95{\%} CI, 0.78 to 1.10; HR for stage II = 0.83; 95{\%} CI, 0.73 to 0.95; and HR for stage III = 0.83; 95{\%} CI, 0.72 to 0.94). The effect of chemotherapy did not vary significantly (test for interaction, P = .11) with the associated drugs, including vinorelbine (HR = 0.80; 95{\%} CI, 0.70 to 0.91), etoposide or vinca alkaloid (HR = 0.92; 95{\%} CI, 0.80 to 1.07), or other (HR = 0.97; 95{\%} CI, 0.84 to 1.13). Chemotherapy effect was higher in patients with better performance status. There was no interaction between chemotherapy effect and sex, age, histology, type of surgery, planned radiotherapy, or planned total dose of cisplatin. Conclusion: Postoperative cisplatin-based chemotherapy significantly improves survival in patients with NSCLC.",
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T1 - Lung adjuvant cisplatin evaluation

T2 - A pooled analysis by the LACE collaborative group

AU - Pignon, Jean Pierre

AU - Tribodet, Hélène

AU - Scagliotti, Giorgio V.

AU - Douillard, Jean Yves

AU - Shepherd, Frances A.

AU - Stephens, Richard J.

AU - Dunant, Ariane

AU - Torri, Valter

AU - Rosell, Rafael

AU - Seymour, Lesley

AU - Spiro, Stephen G.

AU - Rolland, Estelle

AU - Fossati, Roldano

AU - Aubert, Delphine

AU - Ding, Keyue

AU - Waller, David

AU - Le Chevalier, Thierry

PY - 2008

Y1 - 2008

N2 - Purpose: Several recent trials have shown a significant overall survival (OS) benefit from postoperative cisplatin-based chemotherapy in patients with non-small-cell lung cancer (NSCLC). The aim of the Lung Adjuvant Cisplatin Evaluation was to identify treatment options associated with a higher benefit or groups of patients who particularly benefit from postoperative chemotherapy. Patients and Methods: Individual patient data were collected and pooled from the five largest trials (4,584 patients) of cisplatin-based chemotherapy in completely resected patients that were conducted after the 1995 NSCLC meta-analysis. The interactions between patient subgroups or treatment types and chemotherapy effect on OS were analyzed using hazard ratios (HRs) and log-rank tests stratified by trial. Results: With a median follow-up time of 5.2 years, the overall HR of death was 0.89 (95% CI, 0.82 to 0.96; P = .005), corresponding to a 5-year absolute benefit of 5.4% from chemotherapy. There was no heterogeneity of chemotherapy effect among trials. The benefit varied with stage (test for trend, P = .04; HR for stage IA = 1.40; 95% CI, 0.95 to 2.06; HR for stage IB = 0.93; 95% CI, 0.78 to 1.10; HR for stage II = 0.83; 95% CI, 0.73 to 0.95; and HR for stage III = 0.83; 95% CI, 0.72 to 0.94). The effect of chemotherapy did not vary significantly (test for interaction, P = .11) with the associated drugs, including vinorelbine (HR = 0.80; 95% CI, 0.70 to 0.91), etoposide or vinca alkaloid (HR = 0.92; 95% CI, 0.80 to 1.07), or other (HR = 0.97; 95% CI, 0.84 to 1.13). Chemotherapy effect was higher in patients with better performance status. There was no interaction between chemotherapy effect and sex, age, histology, type of surgery, planned radiotherapy, or planned total dose of cisplatin. Conclusion: Postoperative cisplatin-based chemotherapy significantly improves survival in patients with NSCLC.

AB - Purpose: Several recent trials have shown a significant overall survival (OS) benefit from postoperative cisplatin-based chemotherapy in patients with non-small-cell lung cancer (NSCLC). The aim of the Lung Adjuvant Cisplatin Evaluation was to identify treatment options associated with a higher benefit or groups of patients who particularly benefit from postoperative chemotherapy. Patients and Methods: Individual patient data were collected and pooled from the five largest trials (4,584 patients) of cisplatin-based chemotherapy in completely resected patients that were conducted after the 1995 NSCLC meta-analysis. The interactions between patient subgroups or treatment types and chemotherapy effect on OS were analyzed using hazard ratios (HRs) and log-rank tests stratified by trial. Results: With a median follow-up time of 5.2 years, the overall HR of death was 0.89 (95% CI, 0.82 to 0.96; P = .005), corresponding to a 5-year absolute benefit of 5.4% from chemotherapy. There was no heterogeneity of chemotherapy effect among trials. The benefit varied with stage (test for trend, P = .04; HR for stage IA = 1.40; 95% CI, 0.95 to 2.06; HR for stage IB = 0.93; 95% CI, 0.78 to 1.10; HR for stage II = 0.83; 95% CI, 0.73 to 0.95; and HR for stage III = 0.83; 95% CI, 0.72 to 0.94). The effect of chemotherapy did not vary significantly (test for interaction, P = .11) with the associated drugs, including vinorelbine (HR = 0.80; 95% CI, 0.70 to 0.91), etoposide or vinca alkaloid (HR = 0.92; 95% CI, 0.80 to 1.07), or other (HR = 0.97; 95% CI, 0.84 to 1.13). Chemotherapy effect was higher in patients with better performance status. There was no interaction between chemotherapy effect and sex, age, histology, type of surgery, planned radiotherapy, or planned total dose of cisplatin. Conclusion: Postoperative cisplatin-based chemotherapy significantly improves survival in patients with NSCLC.

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