Adjuvant Chemo After Surgery Improves OS in Patients With NSCLC and Brain Metastasis

Patients with non-small cell lung cancer (NSCLC) and synchronous brain metastasis demonstrate improved 1-year and 5-year overall survival (OS) after thoracic surgery and systemic chemotherapy, according to research presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).

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Recent studies have shown that patients with early-stage NSCLC and solitary brain metastasis demonstrate prolonged survival if they undergo surgical resection of both primary and metastatic tumors. However, the role of adjuvant chemotherapy after thoracic surgery for these patients is not well documented or researched.

Researchers from the University of Buffalo (NY) conducted a study to determine the effect on OS of adjuvant chemotherapy after surgical resection of primary and metastatic tumors in patients with NSCLC. Using the National Cancer Data Base, researchers sampled patients with nodal stage 0 (n = 419) or nodal stage 1 (n = 101) who were diagnosed with synchronous brain metastasis from 2010 to 2014. Patients were grouped based on whether or not they received adjuvant chemotherapy within 3 months post-surgery.

Researchers reported no imbalance in terms of gender, race, income, nodal status, or histology between groups. Patients in the non-adjuvant chemotherapy group were older (median age, 64 years vs 58 years in the adjuvant chemotherapy group).

Results of the analysis showed that 1-year and 5-year median OS in the adjuvant chemotherapy group versus the non-adjuvant chemotherapy group was 83% (95% CI, 78%-87%) and 33% (95% CI, 25%-40%), compared with 57% (95% CI, 48%-65%) and 18% (95% CI, 11%-26%), respectively.

Authors of the study acknowledged that age, nodal status, adjuvant chemotherapy, and histology were associated with OS in both univariate and multivariate analyses.

Authors concluded that adjuvant chemotherapy after thoracic surgery for nodal 0-1 NSCLC with synchronous brain metastasis is associated with improved OS.

“Our study shows that adjuvant chemotherapy would be beneficial for patients with lung cancer and brain metastasis and should be implemented into general clinical practice,” one of the authors commented.—Zachary Bessette

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