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Gregory J. Riely, MD, PhD


Could Adjuvant Chemotherapy Improve Survival Among High-Risk Patients With Stage IB NSCLC?

By: Chris Schimpf, BS
Posted: Thursday, February 1, 2024

A Chinese study published in the Journal of Cardiothoracic Surgery found that the use of adjuvant chemotherapy improved survival among high-risk patients with completely resected stage IB non–small cell lung cancer (NSCLC). Noting the potential of these results to aid in treatment planning and patient decision-making, Jun Zhao, MD, PhD, of the First Affiliated Hospital of Soochow University, China, and colleagues stressed the need for further large, multicenter studies and randomized clinical trials with large sample sizes.

“Although adjuvant chemotherapy is the standard therapy for NSCLC in stage II to IIIA, it is still controversial whether adjuvant chemotherapy improves survival in patients with stage IB NSCLC,” the investigators stated. “[Among low-risk study participants], the survival period was relatively long regardless of chemotherapy. In contrast, in high-risk patients, the use of adjuvant chemotherapy improved disease-free survival and overall survival…. [Our] results suggest that our definitions of low-and high-risk groups [were] appropriate and that this grouping may be useful for decision-making in adjuvant chemotherapy for stage IB NSCLC.”

A total of 334 patients with pT2aN0M0 stage IB NSCLC who underwent complete resection from 2013 to 2017 were included in the single-center, retrospective study. The researchers reported that among patients at high risk of recurrence, adjuvant chemotherapy resulted in significantly longer disease-free survival (hazard ratio [HR] = 0.4689; 95% confidence interval [CI] = 1.193–3.818; P = .0108) and overall survival (HR = 0.4696; 95% CI = 0.6578–6.895; P = .2073), although overall survival failed to reach statistical significance. Among patients at low risk of recurrence, disease-free survival (HR = 0.4831; 95% CI = 0.03025–7.715; P = .6068) and overall survival (HR = 0.969; 95% CI = 0.08364–11.21; P = .9794) did not significantly differ between those who received adjuvant chemotherapy and those who did not.

Disclosure: The study authors reported no conflicts of interest.

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