Number of cycles of cisplatin for early stage NSCLC

Portal Forums Cancer Treatments / Symptom Management Conventional Chemotherapy Number of cycles of cisplatin for early stage NSCLC

This topic contains 2 replies, has 3 voices, and was last updated by Dr West Dr West 2 years, 10 months ago.

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January 6, 2015 at 9:24 am  #1267856    

emaxcy

I have had a fully resected (ULL) tumor. no lymph involvement. Tumor 6cm. Mop-up chemo recommended.

Can you point me in the direction of data or studies that discuss/examine the optimum number of chemotherapy cycles (Cisplatin/Alimta)? I know that 4 is the standard for my profile.

Also, are their any studies that weigh the impact/effectiveness of doing only some cycles instead of all 4?
emaxcy

January 6, 2015 at 10:06 am  #1267858    
JimC Forum Moderator
JimC Forum Moderator

Hi emaxcy,

Welcome to GRACE. There is a discussion of the number of cycles of adjuvant chemo here: http://cancergrace.org/topic/3-rounds-versus-4-rounds-of-cisplatinvinerolbine-info-please As you can see from the faculty comments, there isn’t even evidence that four cycles are necessary for the best results.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

January 6, 2015 at 8:48 pm  #1267877    
Dr West
Dr West

The only real evidence we have is from the Canadian BR.10 trial. A post-hoc study looked at outcomes in patients who either had treatment discontinued or stopped treatment based on their own decision due to side effects, and compared results to patients who hadn’t received any post-operative chemo or who had received the full 4 cycles. There was no difference in outcomes between the patients who stopped after 1-3 cycles and those who received 4 cycles: both groups benefited compared with patients who received no chemotherapy after surgery.

That said, we favor trying to get in 4 cycles if patients are tolerating it, but if patients want or need to stop earlier, they still seem to benefit.

Good luck.

-Dr. West

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