TY - JOUR
T1 - Long-term outcomes of operable stage III NSCLC in the pre-immunotherapy era
T2 - results from a pooled analysis of the SAKK 16/96, SAKK 16/00, SAKK 16/01, and SAKK 16/08 trials
AU - König, D.
AU - Schär, S.
AU - Vuong, D.
AU - Guckenberger, M.
AU - Furrer, K.
AU - Opitz, I.
AU - Weder, W.
AU - Rothschild, S. I.
AU - Ochsenbein, A.
AU - Zippelius, A.
AU - Addeo, A.
AU - Mark, M.
AU - Eboulet, E. I.
AU - Hayoz, S.
AU - Thierstein, S.
AU - Betticher, D. C.
AU - Ris, H. B.
AU - Stupp, R.
AU - Curioni-Fontecedro, A.
AU - Peters, S.
AU - Pless, M.
AU - Früh, M.
N1 - Funding Information:
We thank the patients and their families for their participation in the studies, and the investigators and staff for their contributions. This work was supported by an unrestricted grant from AstraZeneca (no grant number), as well as research agreements with the following institutions: Swiss State Secretary for Education (no grant number), Research and Innovation (SERI) (no grant number), Swiss Cancer Research Foundation (SCS), and Swiss Cancer League (SCL) (no grant numeber). DK: consulting or advisory role: AstraZeneca (AZ) (fee to institution). IO: grants (all fees to institution): Roche, Medtronic; honoraria (all fees to speakers bureau): AZ, Roche; advisory role: AZ, Merck, Sharp, and Dohme (MSD). WW: honoraria, consulting or advisory role, travel/accommodations: AZ, Medtronic. SIR: honoraria, consulting or advisory role (all fees to institution): AbbVie, Amgen, AZ, Boehringer Ingelheim, Bristol-Myers Squibb (BMS), Eli Lilly, Eisai, Janssen, MSD, Merck Serono, Novartis, PharmaMar, Pfizer, Roche, Takeda; travel/accommodations: Boehringer Ingelheim, BMS, Roche; Research support: AZ, Roche. AA: consulting or advisory role: AZ, Astella, BMS, MSD, Novartis, Roche; honoraria: AZ, Eli Lilly, Novartis. MM: consulting or advisory role: AZ (institution), BMS, Janssen, MSD, Roche. SP (all fees to institution): consulting or advisory role: AbbVie, Amgen, AZ, Bayer, Beigene, Biocartis, Boehringer Ingelheim, BMS, Clovis, Daiichi Sankyo, Debiopharm, ecancer, Eli Lilly, Elsevier, Fishawack, Foundation Medicine, Illumina, Imedex, IQVIA, Incyte, Janssen, Medscape, MSD, Merck Serono, Merrimack, Novartis, OncologyEducation, PharmaMar, Phosplatin Therapeutics, PER, Pfizer, PRIME, Regeneron, RMEI, Roche/Genentech, RTP, Sanofi, Seattle Genetics, Takeda, Talk: AZ, Boehringer Ingelheim, BMS, ecancer, Eli Lilly, Illumina, Imedex, Medscape, MSD, Novartis, PER, Pfizer, Prime, Roche/Genentech, RTP, Sanofi, Takeda; Grants/research support: Amgen, AZ, Biodesix, Boehringer Ingelheim, BMS, Clovis, GSK, Illumina, Lilly, MSD, Merck Serono, Mirati, Novartis, and Pfizer, Phosplatin Therapeutics, Roche/Genentech. MP: honoraria: Bayer, Janssen, Nestle; consulting or advisory role: AbbVie, Amgen, AZ, Bayer, Boehringer Ingelheim, BMS, Eisei, Janssen, MSD, Merck Serono, Nestle, Novartis, Pfizer, Roche, Sanofi, Takeda; travel/accommodations: AZ, Boehringer Ingelheim, BMS, Roche, Takeda, Vifor. MF: grants (all to institution): AZ, BMS; consulting or advisory role: AZ, Boehringer Ingelheim, BMS, MSD, Pfizer, Roche, Takeda; travel/accommodations: Merck Serono. All other authors have declared no conflicts of interest.
Funding Information:
This work was supported by an unrestricted grant from AstraZeneca (no grant number), as well as research agreements with the following institutions: Swiss State Secretary for Education (no grant number), Research and Innovation (SERI) (no grant number), Swiss Cancer Research Foundation (SCS), and Swiss Cancer League (SCL) (no grant numeber).
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
KW - long-term outcomes
KW - neoadjuvant therapy
KW - operable stage III non-small-cell lung cancer
KW - prognostic factors
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85127725748&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127725748&partnerID=8YFLogxK
U2 - 10.1016/j.esmoop.2022.100455
DO - 10.1016/j.esmoop.2022.100455
M3 - Article
C2 - 35398718
AN - SCOPUS:85127725748
SN - 2059-7029
VL - 7
JO - ESMO Open
JF - ESMO Open
IS - 2
M1 - 100455
ER -
