Long term survival in stage IIIb non-small cell lung cancer (NSCLC) treated with consolidation docetaxel following concurrent chemoradiotherapy (SWOG S9504)

Abstract

7059 Background: The optimal approach to chemoradiotherapy for unresectable stage III NSCLC remains unclear. We have previously reported the efficacy of consolidation docetaxel (D) following concurrent cisplatin-etoposide (PE) and thoracic radiotherapy (RT) in stage IIIb NSCLC in which documentation of T4 (non-effusion) or N3 status was required (S9504). Methods: Here we update results in regard to survival at 5 years in 83 patients (pts) treated with P: 50 mg/m2 days 1, 8, 29 and 36, E: 50 mg/m2 days 1–5 and 29–33 and concurrent thoracic RT starting day 1: 61 Gy (1.8–2.0 Gy/day), followed by consolidation docetaxel 75–100 mg/m2 every 21 days for 3 cycles. Results: Median age 60 (34–80), male/female: 61/22, performance status: 0–1/2:78/5, TNM: T4N0–1: 31, T4N2: 22, N3: 30. Median follow-up: 71 months (mos). Median progression-free survival (PFS): 16 mos. Median survival (MST): 26 mos. 5 year survival: 29%. MST and 5 year survival for Stage IIIb subsets: T4N0–1: 32 mos and 29%: T4N2: 26 mos and 37%; N3: 16 mos and 20%. Survival data are compared below to SWOG 9019, which treated a similarly staged IIIb cohort of 50 pts with identical concurrent chemoradiotherapy, differing only in substitution of consolidation docetaxel for continued PE. Conclusions: 1) Long term survival endpoints achieved in S9504 in documented Stage IIIb NSCLC compare favorably with the SWOG historical control (S9019) and other published series in this pt population. 2) 5 year survival of stage IIIb subsets ranges from 20–37%. 3) Ongoing intergroup trial S0023 is further evaluating the S9504 regimen followed by maintenance therapy with the EGFR inhibitor gefitinib or placebo (Supported by CA 30102). Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis