Non-Small Cell Lung Cancer Coverage from Every Angle

Smoking Behavior in Patients With Early-Stage NSCLC Enrolled in Clinical Trial

By: Sarah Campen, PharmD
Posted: Wednesday, March 3, 2021

In reportedly the first comprehensive, prospective study of smoking habits, patients with non–small cell lung cancer (NSCLC) who enrolled in a phase III early-stage trial showed a high rate of smoking reduction and cessation. According to the report published in the Journal of Thoracic Oncology, 94% of respondents reported smoking fewer cigarettes daily—or had quit smoking altogether—at 12 months compared with baseline.

“We believe tobacco cessation interventions should be incorporated into clinical trial design,” stated Joan H. Schiller, MD, of Inova Schar Cancer Institute, Falls Church, Virginia, and colleagues. “Focusing on tobacco cessation in clinical trials may translate to real-world practice and has the potential to make a significant difference for patients diagnosed with lung cancer.”

The authors studied the smoking behavior of 1,501 patients enrolled in the ECOG-ACRIN 1505 study, a phase III trial that sought to determine whether the addition of bevacizumab to adjuvant chemotherapy would improve overall survival following resection of stage IB to IIIA NSCLC. Patients completed a questionnaire about their smoking habits at baseline, 3, 6, 9, and 12 months.

A total of 90% of respondents reported a current or previous history of cigarette smoking. Of the patients who reported smoking at the time of their lung cancer diagnosis but no longer by the time of study enrollment (n = 689), just 1% reported smoking at 12 months. The authors reported that disease-free survival for never-smokers was similar to that for current and former smokers. Still, there were fewer grade 3 to 5 toxicities and more favorable overall survival in never-smokers.

Disclosure: For full disclosures of the study authors, visit

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