Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer

Christina D. Williams, Ajeet Gajra, Apar Kishor P Ganti, Michael J. Kelley

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non-small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8-year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22% of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0%, 29.8%, and 29.5%, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95% CI, 0.67-0.91) and 2006 through 2008 (HR, 0.79; 95% CI, 0.69-0.91). Of those patients receiving AC, 89% received platinum-doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43% in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95% CI, 0.80-1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939-1947.

Original languageEnglish (US)
Pages (from-to)1939-1947
Number of pages9
JournalCancer
Volume120
Issue number13
DOIs
StatePublished - Jul 1 2014

Fingerprint

Adjuvant Chemotherapy
Non-Small Cell Lung Carcinoma
Survival
Confidence Intervals
Carboplatin
Cisplatin
Neoplasms
Veterans
Platinum
Registries
Regression Analysis
Clinical Trials
Drug Therapy

Keywords

  • adjuvant drug therapy
  • non-small cell lung cancer
  • survival
  • veterans

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer. / Williams, Christina D.; Gajra, Ajeet; Ganti, Apar Kishor P; Kelley, Michael J.

In: Cancer, Vol. 120, No. 13, 01.07.2014, p. 1939-1947.

Research output: Contribution to journalArticle

Williams, Christina D. ; Gajra, Ajeet ; Ganti, Apar Kishor P ; Kelley, Michael J. / Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer. In: Cancer. 2014 ; Vol. 120, No. 13. pp. 1939-1947.
@article{aecb477a6bb24b26ad9912b2d44743fb,
title = "Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer",
abstract = "BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non-small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8-year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95{\%} confidence intervals (95{\%} CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22{\%} of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0{\%}, 29.8{\%}, and 29.5{\%}, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95{\%} CI, 0.67-0.91) and 2006 through 2008 (HR, 0.79; 95{\%} CI, 0.69-0.91). Of those patients receiving AC, 89{\%} received platinum-doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43{\%} in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95{\%} CI, 0.80-1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939-1947.",
keywords = "adjuvant drug therapy, non-small cell lung cancer, survival, veterans",
author = "Williams, {Christina D.} and Ajeet Gajra and Ganti, {Apar Kishor P} and Kelley, {Michael J.}",
year = "2014",
month = "7",
day = "1",
doi = "10.1002/cncr.28679",
language = "English (US)",
volume = "120",
pages = "1939--1947",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "13",

}

TY - JOUR

T1 - Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer

AU - Williams, Christina D.

AU - Gajra, Ajeet

AU - Ganti, Apar Kishor P

AU - Kelley, Michael J.

PY - 2014/7/1

Y1 - 2014/7/1

N2 - BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non-small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8-year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22% of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0%, 29.8%, and 29.5%, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95% CI, 0.67-0.91) and 2006 through 2008 (HR, 0.79; 95% CI, 0.69-0.91). Of those patients receiving AC, 89% received platinum-doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43% in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95% CI, 0.80-1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939-1947.

AB - BACKGROUND Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non-small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends to broader populations. The current study evaluated patterns of AC use and examined the impact of AC on survival. METHODS A retrospective analysis was conducted of patients in the Veterans Affairs Central Cancer Registry diagnosed with stages IB to IIIA NSCLC between 2001 and 2008. Descriptive statistics were used to examine patterns of AC use over an 8-year time period. Cox proportional hazards regression analyses were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CIs) to compare mortality risk among patients treated with and without AC. RESULTS Among 14,306 patients with stages IB to IIIA NSCLC, 4929 underwent surgery and 22% of these received AC. The percentages of patients diagnosed in 2001 through 2003, 2004 through 2005, and 2006 through 2008 receiving AC were 7.0%, 29.8%, and 29.5%, respectively. There was no survival benefit with AC noted for patients diagnosed between 2001 and 2003, but AC was associated with improved survival for the period between 2004 and 2005 (HR, 0.78; 95% CI, 0.67-0.91) and 2006 through 2008 (HR, 0.79; 95% CI, 0.69-0.91). Of those patients receiving AC, 89% received platinum-doublet chemotherapy. Carboplatin remained the most common agent, although cisplatin use reached 43% in the period between 2006 and 2008. The HR for cisplatin relative to carboplatin was 0.96 (95% CI, 0.80-1.15). CONCLUSIONS There was a significant increase in the use of AC between 2001 and 2008 and AC was associated with an improvement in overall survival. Cancer 2014;120:1939-1947.

KW - adjuvant drug therapy

KW - non-small cell lung cancer

KW - survival

KW - veterans

UR - http://www.scopus.com/inward/record.url?scp=84902553607&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902553607&partnerID=8YFLogxK

U2 - 10.1002/cncr.28679

DO - 10.1002/cncr.28679

M3 - Article

VL - 120

SP - 1939

EP - 1947

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 13

ER -