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Effect of second- vs third-generation chemotherapy regimens on unresectable stage III non–small-cell lung cancer

JAMA Jun 22, 2021

Zenke Y, Tsuboi M, Chiba Y, et al. - This multicenter, phase 3 West Japan Thoracic Oncology Group (WJTOG) 0105 randomized clinical trial was performed to assess survival as well as late toxic impacts 10 years after patients with unresectable stage III non–small-cell lung cancer were treated with curative chemoradiotherapy (CRT). Overall 440 eligible patients were randomized to groups as follows: A (control), 4 cycles of mitomycin/vindesine/cisplatin plus thoracic radiotherapy (TRT) of 60 Gy; B, weekly irinotecan/carboplatin for 6 weeks plus TRT of 60 Gy followed by 2 courses of irinotecan/carboplatin consolidation; or C, weekly paclitaxel/carboplatin for 6 weeks plus TRT of 60 Gy followed by 2 courses of paclitaxel/carboplatin consolidation. The 10-year survival probabilities were estimated to be 13.6%, 7.5%, and 15.2% in groups A, B, and C, respectively. Overall survival did not differ significantly among treatment groups. In groups A, B, and C, the estimated 10-year progression-free survival probabilities were 8.5%, 6.5%, and 11.1%, respectively. Findings of this 10-year follow-up of a phase 3 randomized clinical trial revealed that efficacy and toxic effect profiles achieved in group C were similar to those obtained in group A 10 years after initiating treatment. These findings afford a historical control for the long-term comparisons of results of future clinical trials of CRT.

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