Chemotherapy after surgery improves lung-cancer survival
By Andrew Pollack
The New York Times
NEW ORLEANS — Lung-cancer patients whose tumors are removed by surgery can improve their long-term odds of survival if they have chemotherapy after their operation, according to conclusions from two clinical trials announced at a cancer conference yesterday.
The findings could alter the standard of care, making drug treatment after surgery as routine for lung cancer as it is for breast cancer or colon cancer, doctors said at the annual meeting of the American Society of Clinical Oncology. Such a change in treatment could save thousands of lives per year, they said.
"I think the collective data from these two studies are quite compelling to move to a change in the standard of care," said Dr. Timothy Winton of the National Cancer Institute of Canada, the lead author of one of the studies.
In Winton's trial, which involved 482 patients in Canada and the United States, 69 percent of those who received chemotherapy were alive after five years, compared with 54 percent of those who had surgery but no drugs afterward.
In the other study, involving 344 patients in the United States, 71 percent of those who had chemotherapy after surgery were alive after four years, compared with 59 percent in the group that had only surgery. The risk of dying from lung cancer specifically, as opposed to other causes, was cut in half.
Lung cancer by far is the leading killer among cancers. About 200,000 people in North America are found to have lung cancer each year, and perhaps 50,000 may be eligible for chemotherapy after surgery, doctors said.
Previous studies had failed to demonstrate a benefit in lung cancer for such adjuvant chemotherapy, designed to fight any cancer that might have escaped surgery. And because chemotherapy has unpleasant and even dangerous side effects, doctors and patients have been reluctant to use it.
But the investigators said the side effects in their trials generally were tolerable and that benefits outweighed the risk.
In Winton's trial, patients received chemotherapy — the drugs cisplatin and vinorelbine — for 16 weeks.
The other study used paclitaxel and carboplatin for 12 weeks. In other studies presented at the conference, two so-called targeted therapies developed by biotechnology companies were found to have extended the lives of people with cancer.