Chemotherapy in Lung Cancer: Evaluating Timing for Adjuvant Treatment

Timing of adjuvant chemotherapy after a patient undergoes resection for non-small cell lung cancer may be a factor of overall survival.
Timing of adjuvant chemotherapy after a patient undergoes resection for non-small cell lung cancer may be a factor of overall survival.

Timing of adjuvant chemotherapy after a patient undergoes resection for non-small cell lung cancer (NSCLC) may be a factor of overall survival, according to an article published in JAMA Oncology.1

Adjuvant chemotherapy is standard for patients with lymph node metastases, tumors of at least 4cm, or extensive invasion locally. There is, however, no consensus on the best time to administer this therapy; researchers therefore consulted the National Cancer Database to determine the optimal time of therapy administration.

Of 1,039,990 patients with NSCLC were identified through the database, 31,474 were categorized into 4 groups after exclusion: 3359 patients who received adjuvant therapy fewer than 39 days post-resection, 5137 patients treated 39 to 56 days post-resection, 3977 patients treated more than 56 days post-resection, and 19,001 patients who did not receive adjuvant therapy.

No significant survival differences were when patients were treated up to 4 months after surgery; the authors noted, however, that “a small but significant difference in survival exists based on when chemotherapy is given but is not able to be appreciated within this data set.”

Some sociodemographic factors were associated with a delay in receipt of adjuvant treatment, including advanced age, not having medical insurance, and low education; this finding illustrates a need for physician awareness of a patient's socioeconomic status to ensure receipt of timely treatment.

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The authors concluded that patients with NSCLC benefit from adjuvant chemotherapy up to 4 months post-resection, though further studies are needed to confirm this.

Reference

  1. Salazar MC, Rosen JE, Zuoheng W, et al. Association of delayed adjuvant chemotherapy with survival after lung cancer surgery. JAMA Oncol. 2017 Jan 5. doi: 10.1001/jamaoncol.2016.5829 [Epub ahead of print]

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