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Comparing Preoperative and Perioperative Chemotherapies: Presented at ELCC By Timothy A. O'Leary GENEVA -- April 25, 2008 -- Two cycles of chemotherapy before surgery might be as effective as 4 in patients with operable stage I or stage II non-small-cell lung cancer (NSCLC), according to a study presented here at the 1st European Lung Cancer Conference (ELCC). The study of 528 patients with NSCLC showed that there was no significant difference in pathological response between 2 preoperative cycles of chemotherapy and 4, said investigator Virginie Westeel, MD, Pulmonologist, Chest Disease Department, University Hospital of Besançon, France. "The addition of 2 preoperative [chemotherapy] cycles in responders did not influence tumour volume, intratumoural necrosis, pleural, venous, or intrapulmonary lymphatic invasions," she said in a presentation on April 24. "Pathological complete response rates were not statistically different." The odds that a patient would die during the first 30 days after surgery were the same regardless of whether he had received 2 or 4 preoperative cycles of chemotherapy, she said. The odds that a patient would die of a toxic reaction during the first 6 months after surgery were also the same regardless of whether he had received 2 or 4 preoperative cycles of chemotherapy, she said. The researchers evaluated 2 different drug regimens: gemcitabine-cisplatin and paclitaxel-carboplatin. They found both to be effective and safe, though toxic in different ways. For example, patients who received the gemcitabine-cisplatin regimen were approximately 5.5 times more likely to develop grade 3 or 4 thrombocytopenia than the patients who received the paclitaxel-carboplatin regimen. In addition, patients who received gemcitabine-cisplatin were approximately 5.25 times more likely to develop grade 2 nausea than the patients who received paclitaxel-carboplatin. By contrast, patients who received paclitaxel-carboplatin were nearly 4 times more likely to develop neuropathy after 6 months than the patients who received gemcitabine-cisplatin. It is certainly feasible to administer 4 cycles of chemotherapy before surgery, Dr. Westeel said. Indeed, patients were more likely to comply with their third and fourth cycles of chemotherapy if they were administered before surgery rather than after, the researchers found. She noted that the quality of life of patients was the same in the 2 treatment arms. "Everybody got 2 cycles of chemotherapy," she said. "If they did not respond, the nonresponders will get 2 [more] cycles of chemotherapy plus surgery." NSCLC is the most common form of lung cancer. [Presentation title: Phase III Study Comparing Preoperative and Perioperative Chemotherapy With Two Different Chemotherapy Regimens in Respectable Stage I-II Non-Small Cell Lung Cancer: The IFCT 0002 Protocol. Abstract 27IN] E-mail this page to a friend or colleague! To print, use this version