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| |  Adding Tegafur-Uracil to Surgery Improves Survival in Patients With Stage IA-T1a NSCLC: Presented at ECCO-ESMO By Chris Berrie BERLIN -- September 30, 2009 -- Compared with surgery alone, postoperative adjuvant chemotherapy with tegafur-uracil (UFT) significantly improves survival in patients with stage IA-T1a non-small-cell lung cancer (NSCLC), according to a meta-analysis presented here September 22 at the joint 15th Congress of the European Cancer Organisation (ECCO) and 34th Congress of the European Society for Medical Oncology (ESMO). In stage I NSCLC, “the postoperative survival rate remains unsatisfactory even after complete tumour resection,” said principal investigator Masahiru Tsuboi, MD, Lung Cancer Study Surgical Group, and Thoracic Surgery, Kanagawa Cancer Centre, Yokohama, Japan. Thus, in patients with NSCLC and clinical stage IA-T1 disease, there remains the need for postoperative adjuvant therapy to improve survival. Previous analyses have shown that the combination of tegafur with uracil can improve survival of patients with stage I NSCLC, and particularly those of stage IB. However, whether it is effective in patients with T1 disease (stage IA) remains controversial. The International Association for the Study of Lung Cancer-American Joint Committee on Cancer staging committees recently updated the lung cancer staging classification system. Stage IA-T1 is now comprised of T1a (tumour size, <=2 cm) and T1b (tumour size, >2 to <=3 cm) disease. The aim of this study was to evaluate the effectiveness of UFT in patients with T1a and T1b tumours in stage IA NSCLC. Researchers pooled data from 6 Japanese randomised controlled studies in which patients aged younger than 76 years with NSCLC stage I to III were randomised to receive either surgery or surgery followed by UFT monotherapy. Complete resection had to have been achieved, with no previous anticancer therapies. Patients were followed up for at least 5 years. Patients with T1N0 disease were identified and divided into 2 groups, according to T1a (n = 670) and T1b tumours (n = 599) In the T1a tumour dataset, UFT treatment did not provide any significant benefit over surgery alone for 5-year overall survival (OS; P = .37). In contrast, 5-year OS saw a 6% absolute benefit in patients with T1b tumours receiving UFT treatment following surgery versus surgery alone (82% vs 88%; P = .011). In a further survival analysis of these patients according to age, gender, and histological type, “There was no difference in the effectiveness of the UFT adjuvant treatment among any of these subgroups,” Dr. Tsuboi noted. “In clinical practice, at least in Japan, postoperative adjuvant treatment with UFT should be considered in patients with T1b-T2N0M0 NSCLC,” concluded Dr. Tsuboi.
[Presentation title: Efficacy of Post-Operative Adjuvant Chemotherapy With Tegafur-Uracil (UFT) on Survival in Patients With Stage IA Non-Small-Cell Lung Cancer: An Exploratory Analysis From a Meta-Analysis of 6 Randomised Controlled Trials. Abstract 9014]
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