Pre-operative chemotherapy in early stage resectable non-small-cell lung cancer: A randomized feasibility study justifying a multicentre phase III trial

R. H. De Boer, I. E. Smith, U. Pastorino, M. E R O'Brien, F. Ramage, S. Ashley, P. Goldstraw

Research output: Contribution to journalArticle

Abstract

Surgical resection offers the best chance for cure for early stage non-small-cell lung cancer (NSCLC, stage I, II, IIIA), but the 5-year survival rates are only moderate, with systemic relapse being the major cause of death. Pre-operative (neo-adjuvant) chemotherapy has shown promise in small trials restricted to stage IIIA patients. We believe similar trials are now appropriate in all stages of operable lung cancer. A feasibility study was performed in 22 patients with early stage (IB, II, IIIA) resectable NSCLC; randomized to either three cycles of chemotherapy [mitomycin-C 8 mg m-2, vinblastine 6 mg m-2 and cisplatin 50 mg m-2 (MVP)] followed by surgery (n = 11), or to surgery alone. Of 40 eligible patients, 22 agreed to participate (feasibility 55%) and all complied with the full treatment schedule. All symptomatic patients achieved either complete (50%) or partial (50%) relief of tumour-related symptoms with pre-operative chemotherapy. Fifty-five per cent achieved objective tumour response, and a further 27% minor tumour shrinkage, none had progressive disease. Partial pathological response was seen in 50%. No severe (WHO grade III-IV) toxicities occurred. No significant deterioration in quality of life was detected during chemotherapy. Pre-operative MVP chemotherapy is feasible in early stage NSCLC, and this study has now been initiated as a UK-wide Medical Research Council phase III trial.

Original languageEnglish
Pages (from-to)1514-1518
Number of pages5
JournalBritish Journal of Cancer
Volume79
Issue number9-10
Publication statusPublished - 1999

Keywords

  • Cisplatin
  • Mitomycin-C
  • Non-small-cell lung cancer
  • Pre-operative chemotherapy
  • Vinblastine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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