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Article

Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy

University of Ottawa, The Ottawa Hospital, and The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(6), 386-390; https://doi.org/10.3747/co.23.3191
Submission received: 7 September 2016 / Revised: 10 October 2016 / Accepted: 12 November 2016 / Published: 1 December 2016

Abstract

Introduction: Despite adjuvant systemic therapy in patients with completely resected non-small-cell lung cancer (NSCLC), many will subsequently relapse. We investigated treatment choices at relapse and assessed the effect of palliative platinum doublet systemic therapy in this population. Methods: With research ethics board approval, we performed a retrospective chart review of all patients with resected NSCLC who received adjuvant systemic therapy from January 2002 until December 2008 at our institution. The primary outcome was the response rate to first-line palliative systemic therapy among patients who relapsed. Results: We identified 176 patients who received adjuvant platinum doublet systemic therapy (82% received cisplatin–vinorelbine). In the 85 patients who relapsed (48%), median time to relapse was 18.5 months (95% confidence interval: 15 months to 21.3 months). Palliative systemic therapy was given in 43 patients. Of those 43 patients, 25 (58%) were re-challenged with platinum doublet systemic therapy, with a response rate of 29% compared with 18% in 18 patients who received other systemic therapy (p = 0.48). We observed a trend toward an increased clinical benefit rate (complete response + partial response + stable disease) in patients who were treated with a platinum doublet (67% vs. 41%, p = 0.12). Median overall survival (OS) from relapse was 15.3 months in patients receiving palliative systemic therapy and 7.8 months in those receiving best supportive care alone. Compared with patients treated with non-platinum regimens, the platinum-treated group experienced longer survival after relapse (18.4 months vs. 9.7 months, p = 0.041). Conclusions: In patients previously treated with adjuvant systemic therapy, re-treatment with platinum doublet chemotherapy upon relapse is feasible. Moreover, compared with patients receiving other first-line systemic therapy, patients receiving platinum doublets experienced higher response rates and significantly longer survival.
Keywords: recurrent non-small-cell lung cancer; adjuvant therapy; first-line therapy; platinum recurrent non-small-cell lung cancer; adjuvant therapy; first-line therapy; platinum

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MDPI and ACS Style

Valdes, M.; Nicholas, G.; Goss, G.D.; Wheatley-Price, P. Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy. Curr. Oncol. 2016, 23, 386-390. https://doi.org/10.3747/co.23.3191

AMA Style

Valdes M, Nicholas G, Goss GD, Wheatley-Price P. Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy. Current Oncology. 2016; 23(6):386-390. https://doi.org/10.3747/co.23.3191

Chicago/Turabian Style

Valdes, M., G. Nicholas, G.D. Goss, and P. Wheatley-Price. 2016. "Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy" Current Oncology 23, no. 6: 386-390. https://doi.org/10.3747/co.23.3191

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