430P - Comparison of multimodality therapy in clinical stage IIIAN2 non-small cell lung cancer: consecutive analysis of surgery, radiotherapy, chemotherap...

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Non-Small-Cell Lung Cancer, Locally Advanced
Surgical Oncology
Presenter Yuki Katsuya
Citation Annals of Oncology (2016) 27 (suppl_9): ix136-ix138. 10.1093/annonc/mdw593
Authors Y. Katsuya1, H. Horinouchi1, Y. Goto1, S. Kanda1, Y. Fujiwara1, H. Nokihara1, N. Yamamoto1, K. Asakura2, K. Nakagawa2, H. Sakurai2, S. Watanabe2, H. Igaki3, Y. Itou3, J. Itami3, Y. Ohe1
  • 1Department Of Thoracic Oncology, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 2Division Of Thoracic Surgery, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 3Department Of Radiation Oncology, National Cancer Center Hospital, 104-0045 - Tokyo/JP

Abstract

Background

The optimal therapeutic approach for patients (pts) with clinical stage IIIAN2 (cIIIAN2) non-small cell lung cancer (NSCLC) remains controversial.

Methods

To characterize the contemporary results of multimodality treatment, we retrospectively reviewed consecutive pts treated for cIIIAN2 NSCLC at the National Cancer Center between 2002 and 2011. Patient characteristics, modality of treatment, relapse-free survival, and overall survival (OS) were evaluated.

Results

Of the 262 overall pts, 141 (54%) were treated with definitive chemoradiotherapy (CRT), 39 (15%) were treated with sequential chemoradiotherapy (CT/RT), 12 (5%) were treated with induction chemoradiotherapy followed by surgery (CRT/S), 32 (12%) were treated with surgery (S) with or without adjuvant chemotherapy, 17 (6%) were treated with radiotherapy (RT), and 21 (8%) were treated with chemotherapy (C). The pretreatment N2 status was pathologically confirmed (pathocN2) in 34 (24%) pts with CRT, 5 (13%) pts with CT/RT, 10 (83%) pts with CRT/S, 0 (0%) pts with S, 4 (24%) pts with RT, and 6 (29%) pts with C. In the S group, 14 pts were pathological (p) N0 and three pts were pN1 in a postsurgical pathological evaluation. The 5year relapse free and 5year survival rates (in pathocN2 pts) were 11%/18% (21%) in the CRT group, 13%/13% (0%) in the CT/RT group, 25%/42% (45%) in the CRT/S group, 28%/38% (36%) in the S group, 6%/18% (25%) in the RT group, and 0%/0% in the C group.

Conclusions

Based on this practice-based consecutive analysis, multimodality treatment, even when surgery was included as the first approach, showed a better outcome for pts with heterogeneous cIIIAN2 disease. To decipher the potential benefits of surgery, the development of a valid selection method for pts with cIIIAN2 NSCLC is mandatory.

Clinical trial indentification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

H. Horinouchi: Corporate-sponsored research: Taiho, Merck Serono, MSD, Astellas, Novartis. H. Nokihara: Honoraria: Boehringer, Taiho, AstraZeneca, Ono, Sanofi, Lilly Research Funding: Merck, Pfizer, Taiho, Eisai, Chugai, Lilly, Novartis, Daiichi Sankyo, Glaxo, Yakult, Quintiles, Astellas, AstraZeneca, Boehringer, Ono. N. Yamamoto: Research funds (as institutions): Quintiles Astellas Chugai Esai Taiho BMS Pfizer Novartis Daiichi-Sankyo Boehringer Ingelheim Kyowa-Hakko Kirin 2) Honoraria AstraZeneca Pfizer Eli Lilly Chugai. Y. Ohe: Research supports: AstraZeneca, Chugai, zlilli, Ono, BMS, Kyorin, Dainipon-Sumitomo, Pfizer, Taiho, Novartis, Merck honoraia: AstraZeneca, Chugai, Lilly, Ono, BMS, Daiichi-Sankyo, Nipponkayaku, Boehringer, Bayer, MSD, Taiho, Clovis, Sanofi. All other authors have declared no conflicts of interest.