Similar Survival Benefit Observed in Both Simple and Extensive NSCLC Follow-up
Although guidelines advocate follow-ups consisting of clinic visits and CT-scans, there is a lack of robust data supporting these recommendations.
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Follow-up visits to the clinic that are minimal in scope may have the same effect on overall survival as intensive CT-scan-based follow ups in patients with completely resected NSCLC, according to the a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Spain.1
Although guidelines advocate follow-ups consisting of clinic visits and CT-scans, there is a lack of robust data supporting these recommendations. The IFCT-0302 trial (ClinicalTrials.gov Identifier: NCT00198341) is the first randomized trial that investigated follow-up in patients with resected NSCLC.
Researchers randomly assigned 1775 patients with NSCLC who underwent complete resection to 2 study arms. Patients in the experimental arm underwent clinical examination, thoraco-abdominal CT-scan plus bronchoscopy, and chest X-ray, and patients in the control arm only received clinical examinations and chest X-rays. For both study groups follow-ups were performed every 6 months after randomization for the first 2 years, then annually until 5 years.
At a median follow-up of 8.7 years (95% CI, 8.5-9) there was no significant difference in overall survival (OS) between the 2 study arms (hazard ratio [HR], 0.92; 95% CI, 0.8-1.07; P = .27). For the control arm, median OS was 8.2 years (95% CI, 7.4-9.6) compared with 10.3 years (95% CI, 8.5-not reached) in the experimental arm.
The 3-year disease-free survival rates in the control and experimental arms were 63.3% (95% CI, 60.2%-66.5%) and 60.2% (95% CI, 57.0%-63.4%), respectively.
Eight-year OS rates in the control and experimental arms were 51.1% (95% CI, 47.2%-55.1%) and 55.6% (95% CI, 51.7%-59.4%), respectively
Results of this study demonstrate that at the time of median follow-up, there was no significant difference in OS benefit between intensive follow-up compared with routine follow-up. The study authors concluded by saying however, that “a longer follow-up is necessary not to miss a potential long-term OS benefit of CT-scan-based surveillance.”
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- Westeel V, Barlesi F, Foucher P, et al. Results of the phase III IFCT-0302 trial assessing minimal versus CT-scan-based follow-up for completely resected non-small cell lung cancer (NSCLC). Presented at: ESMO 2017 Congress; Madrid, Spain: September 8-12, 2017. Abstract 1273O.