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Consolidation Chemotherapy after Chemoradiation? Not the Right Answer to Not the Right Question?

Consolidation Chemotherapy after Chemoradiation? Not the Right Answer to Not the Right... EDITORIAL Consolidation Chemotherapy after Chemoradiation? Not the Right Answer to Not the Right Question? Walter J. Curran, Jr, MD*† he role of consolidation chemotherapy after concurrent chemo-radiation (chemo-RT) Tfor patients with unresected stage III non–small-cell lung cancer (NSCLC) remains only partially defined. Issues exist with respect to the heterogeneity of this patient popula- tion as well as of the nature of the therapies received, thus making global policies difficult to formulate and even more difficult to execute. Dr. Tsujino and colleagues have tried to address this by ambitiously gathering over 3400 patients from 41 studies and segregating their survival outcome by whether or not they were assigned to receive consolidation che- motherapy. The trials analyzed included mainly single-arm phase II trials, with only seven phase III studies in this data set. The authors conclude from their analysis that the intent to give consolidation chemotherapy was not associated with better survival outcome. The authors acknowledge a number of limitations of this report. These obviously include patient and treatment regimen variability across a very diverse set of trials. I believe there are more important issues to consider. This analysis includes concurrent chemo-RT regimens with the so-called radiosensitizing regimens of low-dose weekly carboplatin- based chemotherapy http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Thoracic Oncology Wolters Kluwer Health

Consolidation Chemotherapy after Chemoradiation? Not the Right Answer to Not the Right Question?

Curran, Walter J.
Journal of Thoracic Oncology , Volume 8 (9) – Sep 1, 2013
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Copyright
Copyright © 2013 by the International Association for the Study of Lung Cancer
ISSN
1556-0864
DOI
10.1097/JTO.0b013e3182a61949
pmid
23945381
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL Consolidation Chemotherapy after Chemoradiation? Not the Right Answer to Not the Right Question? Walter J. Curran, Jr, MD*† he role of consolidation chemotherapy after concurrent chemo-radiation (chemo-RT) Tfor patients with unresected stage III non–small-cell lung cancer (NSCLC) remains only partially defined. Issues exist with respect to the heterogeneity of this patient popula- tion as well as of the nature of the therapies received, thus making global policies difficult to formulate and even more difficult to execute. Dr. Tsujino and colleagues have tried to address this by ambitiously gathering over 3400 patients from 41 studies and segregating their survival outcome by whether or not they were assigned to receive consolidation che- motherapy. The trials analyzed included mainly single-arm phase II trials, with only seven phase III studies in this data set. The authors conclude from their analysis that the intent to give consolidation chemotherapy was not associated with better survival outcome. The authors acknowledge a number of limitations of this report. These obviously include patient and treatment regimen variability across a very diverse set of trials. I believe there are more important issues to consider. This analysis includes concurrent chemo-RT regimens with the so-called radiosensitizing regimens of low-dose weekly carboplatin- based chemotherapy

Journal

Journal of Thoracic Oncology – Wolters Kluwer Health

Published: Sep 1, 2013

References

  • Is consolidation chemotherapy after concurrent chemo-radiotherapy beneficial for patients with locally advanced non-small cell lung cancer? A pooled analysis of the literature
    Tsujino
  • Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer
    Aupérin
  • Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410
    Curran