Long-term outcomes of operable stage III NSCLC in the pre-immunotherapy era: results from a pooled analysis of the SAKK 16/96, SAKK 16/00, SAKK 16/01, and SAKK 16/08 trials
In: König, D; Schär, S; Vuong, Diem; Guckenberger, Matthias; Furrer, K; Opitz, I; Weder, W; Rothschild, 2022
Online
academicJournal
Zugriff:
BACKGROUND Chemoradiotherapy with durvalumab consolidation has yielded excellent results in stage III non-small-cell lung cancer (NSCLC). Therefore, it is essential to identify patients who might benefit from a surgical approach. MATERIAL AND METHODS Data from 437 patients with operable stage III NSCLC enrolled in four consecutive Swiss Group for Clinical Cancer Research (SAKK) trials (16/96, 16/00, 16/01, 16/08) were pooled and outcomes were analyzed in 431 eligible patients. All patients were treated with three cycles of induction chemotherapy (cisplatin/docetaxel), followed in some patients by neoadjuvant radiotherapy (44 Gy, 22 fractions) (16/00, 16/01, 16/08) and cetuximab (16/08). RESULTS With a median follow-up time of 9.3 years (range 8.5-10.3 years), 5- and 10-year overall survival (OS) rates were 37% and 25%, respectively. Overall, 342 patients (79%) underwent tumor resection, with a complete resection (R0) rate of 80%. Patients (n = 272, 63%) with R0 had significantly longer OS compared to patients who had surgery but incomplete resection (64.8 versus 19.2 months, P < 0.001). OS for patients who achieved pathological complete remission (pCR) (n = 66, 15%) was significantly better compared to resected patients without pCR (86.5 versus 37.0 months, P = 0.003). For patients with pCR, the 5- and 10-year event-free survival and OS rates were 45.7% [95% confidence interval (CI) 32.8% to 57.7%] and 28.1% (95% CI 15.2% to 42.6%), and 58.2% (95% CI 45.2% to 69.2%) and 45.0% (95% CI 31.5% to 57.6%), respectively. CONCLUSION We report favorable long-term outcomes in patients with operable stage III NSCLC treated with neoadjuvant chemotherapy with cisplatin and docetaxel ± neoadjuvant sequential radiotherapy from four prospective SAKK trials. Almost two-third of the patients underwent complete resection after neoadjuvant therapy. We confirm R0 resection and pCR as important predictors of outcome.
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Long-term outcomes of operable stage III NSCLC in the pre-immunotherapy era: results from a pooled analysis of the SAKK 16/96, SAKK 16/00, SAKK 16/01, and SAKK 16/08 trials
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Autor/in / Beteiligte Person: | König, D ; Schär, S ; Vuong, Diem ; Guckenberger, Matthias ; Furrer, K ; Opitz, I ; Weder, W ; Rothschild, S I ; Ochsenbein, A ; Zippelius, A ; Addeo, A ; Mark, M ; Eboulet, E I ; Hayoz, S ; Thierstein, S ; Betticher, D C ; Ris, H-B ; Stupp, R ; Curioni-Fontecedro, A ; Peters, S ; Pless, M ; Früh, M |
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Zeitschrift: | König, D; Schär, S; Vuong, Diem; Guckenberger, Matthias; Furrer, K; Opitz, I; Weder, W; Rothschild, 2022 |
Veröffentlichung: | BMJ Publishing Group, 2022 |
Medientyp: | academicJournal |
ISSN: | 2059-7029 (print) |
DOI: | 10.5167/uzh-220865 |
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