Induction Chemotherapy before surgery for Early-Stage Lung Cancer: A Novel Approach

Reviewers: Li Liu, MD
Source: Journal of Thoracic Cardiovascular Surgery, Volume 119:429-439, (March) 2000

Précis: Induction chemotherapy before surgery is effective for non small-cell lung cancer

Introduction

Despite an encouraging decline in the overall death rate of patients with cancer over the last five years, non-small cell lung cancer (NSCLC) remains a formidable problem. An estimated 164,000 new cases will occur in 2000, of which approximately 156,900 will die of disease. Lung cancer ranks first in cancer incidence and cause of cancer death in both men and women. Treatment of NSCLC remains a major challenge for oncologists. In this phase II trial, the researchers assessed the feasibility, response rate, and clinical outcome of preoperative chemotherapy in patients with early-stage NSCLC.

Method

A total of 94 patients with early-stage NSCLC received 2 cycles of preoperative paclitaxel and carboplatin chemotherapy. Patients who underwent complete resection were scheduled to receive 3 additional cycles postoperatively

Results

• 88 patients underwent surgical exploration and 81 had a complete resection performed.
• 6 patients had pathologic complete response.
• One-year and 2-year survival rates were 85% and 56%, respectively.

Discussion

In this study, among patients with early-stage NSCLC who received preoperative induction chemotherapy of paclitaxel and carboplatin, 85% survived for one year. This study involved a highly selected group of patients, and the therapy may not be appropriate for patients with severe co-mobidity and poor performance status.