International adjuvant lung cancer trial (IALT)


74% pts received at least 240mg/m2 of DDP;8% pts assigned to the chemotherapy arm received no chemotherapy The lethal treatment-associated toxicity rate in the chemotherapy arm was 0.8%
Outcome data from IALT
Chemotherapy arm Median survival 5-year survival rate Median disease-free survival 5-year disease-free survival rate Lethal toxicity rate Control 44.4 months 40.4% 30.5 months 34.3% 0 <0.003 P value <0.03 50.8 months 44.5% 40.2 months 39.4% 0.8%
Chemotherapy used in IALT
Adjuvant chemotherapy regimen Cisplatin 300-400mg/m2 over 3-4 cycles with etoposide vinovelbine vinblastin vindesine 56 27 11 6 % of the pts
Highlights from the Tenth World Conference on lung cancer
Tracey L, Evans The oncologist 2004;9:232-238 The conference was held in Vancouver, Canada
ppt made by leeyong
The Big Lung Trial (BLT)




Large, multicenter study in the UK All pts with NSCLC received primary therapy as determined by stage (surgery, radiation, or BSC) Pts randomized to receive either three 3weekly cycles of DDP-based chemotherapy DDP/VDS, MMC/IFO/DDP, MMC/VLB/DDP NVB/DDP, or no chemotherapy
International adjuvant lung cancer trial (IALT)



Thoracic radiotherapy was optional Chemotherapy was administered with 60 days 35% pts in each arm underwent pneuonectomy and the remainder had lobectomy 39% of pts in each arm had stage Ⅲ,and 46% had scc
Adjuvant Chemotherapy in nonsmall-cell lung cancer

International adjuvant lung cancer trial (IALT)
from 1995-2000
1867 pts from 148 centers in 33 countries pts undergone complete resection of NSCLC chemotherapy arm vs observation arm
Adjuvant lung project ITALY(ALPI)
1209 pts with completely resected NSCLC were randomly assigned to received either MMC, VDS, and DDP every 3 weeks for 3 cycles or no chemotherapy 69% of the pts assigned to the chemotherapy arm received all 3 cycles. Stage Ⅲ disease was present in 28%-29% of pts, while the remainder were stage Ⅰor stage Ⅱ
The overall survival hazard ratio for chemotherapy was 0.86 95% CI=0.76-0.98 Absolute 5-year survival benefit of 4.1% Absolute 5-year disease-free survival benefit of 5.1%, and hazard ratio was o.83%
The Big Lung Trial (BLT)Fra bibliotek
In the subgroup of pts receiving BSC as their primary modality, there was a statistically significant survival benefit for chemotherapy There was no benefit to chemotherapy in terms of overall survival or progression-free survival The overall survival hazard ratio for chemotherapy was 1.02 (95%CI=0.77-1.35)