Early-Stage NSCLC Yearns Treatment Satisfaction Improvement
Almost half (47%) of the subjects with early-stage non-small cell lung cancer (NSCLC) in the Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trial (ALCHEMIST) screening study did not undergo lymph node dissection considered adequate by National Comprehensive Cancer Network guidelines, and only 43% received any adjuvant chemotherapy, even though the purpose of the study was to facilitate enrollment into adjuvant therapy clinical trials, according to a retrospective cohort study.
“Standard treatment for resectable [NSCLC] includes anatomic resection with adequate lymph node dissection and adjuvant chemotherapy for appropriate patients…This study suggests that efforts to optimize the use of standard therapy for early NSCLC are needed, and adjuvant trial results for NSCLC should be interpreted in light of potentially suboptimal standard therapy among participants,” wrote lead author Kenneth Kehl, MD, MPH, Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues.
Researchers analyzed data from 2833 patients who participated in the study from August 18, 2014, to April 1, 2019. Subjects had stage IB to IIIA NSCLC under the American Joint Committee on Cancer criteria (7th edition), tumors of at least 4 cm and / or positive lymph nodes, and did not enroll in a therapeutic adjuvant clinical trial. Statistical analysis was conducted from June 1, 2020 until October 1, 2021.
Although 95% of the participants had anatomic surgical resection, only 44% received at least 4 cycles of adjuvant platinum-based chemotherapy, and only 34% received any cisplatin-based adjuvant chemotherapy. Rates were similar across race and ethnicity.
Source:
Kehl KL, Zahrieh D, Yang P, et al. Rates of Guideline-Concordant Surgery and Adjuvant Chemotherapy Among Patients With Early-Stage Lung Cancer in the US ALCHEMIST Study (Alliance A151216). JAMA Oncol. Published online March 17, 2022. doi:10.1001/jamaoncol.2022.0039.
