Author of

• 10720

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  P1.09 - Poster Session 1 - Combined Modality (ID 212)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10722

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    P1.09-002 - Preoperative chemotherapy regimens for locally advanced stage III non-small cell lung carcinoma:<br /> Downstaging depending on histology, age, chemotherapy protocol (ID 200)

    09:30 - 09:30  |  Author(s): M. Bachoor
    • Abstract

    Background
    newly diagnosed patients with Non-small cell lung carcinoma (NSCLC) presented with advanced stages IIIA and IIIB were randomized to receive 3 protocols of neoadjuvant chemotherapy aiming at determining of both (pathologic response, and local-regional control) before undergoing surgery according to the response.

    Methods
    85 enrolled Patients treated from Jan 2009 till Dec 2011 with neoadjuvant chemotherapy. 75 pts males and 10 pts females.48 patientsts (56,5% ) had less than 60 years. 58 patientsts (68,2%) had Squamous cell carcinoma subtype (SCC) , while the other 28 patients (31,8%) had (Non SCC). All patients underwent pretreatment evaluation at AL BAYROUNI University cancer center. Some patients (32%) had complete mediastinoscopy staging, and all were believed to be poor candidates for up-front surgery because of the bulky disease. Different chemotherapeutic protocols were employed (Gemcitabine/cisplatin)(Docetaxel/cisplatine) and( vinorelbine/cisplatine). Study end points included resectability, pathologic response, local-regional control,and the best chemotherapy regimen . An exploratory comparison between pathologic response and both histology and age was performed. On the other hand,An exploratory comparison between the three different regimens of chemotherapy was also done.

    Results
    Of the 85 patients, 26 (30,5%) were deemed surgical candidates after induction therapy however 7 patients of which (8,2%) refused surgery, were 27/85 males and 2/10 females had good downstaging P value (0.0001) and (0.0003) respectively with T downstaging 20/85 (23.5%), and N downstaging 18/85 (21.2%) but T+N downstaging was seen in only 9 patients (10.6%)P value (0,0001).The response to induction chemotherapy was 30/85 patients (35.2%) with one patient only (1.2%)` in a complete response . furthermore, 26/85 patients were in objective response (30.5%) and while 3 patients (3,5%) had a stable disease.Regarding responders' age, there were 18/48 patients (37%) aged 60 years and less, and only 8/37 patients (21.6%) were over 60 years.Depending on response to histology, 21/58 patients (34.5%) of SCC had got a response to preoperative chemotherapy, P value (0,0015), while 10/27 patients (37%) had no SCC,P value ( 0,0295).50/85 patients (58.8%) treated by (Gemcitabine / Cisplatin) protocol with 15 responders( 30%) P value (0,0197 ),24/85 patients (28.2%) treated with (Vinorlbine / Cisplatin) protocol with 11 responders (45.8%) P value(0.0125) . And finally,11/85 of pts (12,9%) treated by (docetaxel / cisplatin) protocol showed four responders (36.4%) P value ( 0,0332 )

    Conclusion
    The preoperative chemotherapy gives a good response for a possible surgery in patients with stages IIIA and IIIB NSCLC. this response was better in patients under 60 years , P value ( 0,0055 ). With response was better seen in Vinorelbine and Cisplatin arm . However , regarding histology based response, there was no preference.the former results lead us to use neoadjuvant chemotherapy in locally advanced NSCLC,but we still need a larger trials to reach the best protocol.