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Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study.

Publication ,  Journal Article
Ahmed, S; Birnbaum, AE; Safran, HP; Dipetrillo, TA; Aswad, BI; Ready, NE; Ng, T
Published in: J Thorac Oncol
August 2011

INTRODUCTION: Pathologic complete response (pCR) to neoadjuvant chemotherapy is associated with improved survival in solid tumors. Southwest Oncology Group 9,900 demonstrated a 9% pCR after three cycles of paclitaxel/carboplatin every 21 days. We evaluated pCR rate with intensive weekly paclitaxel in a phase II study. METHODS: Patients with non-small cell lung cancer, stage IB to IIIA, were eligible and received carboplatin, area under the curve = 6, every 21 days ×3 and paclitaxel 80 mg/m weekly ×9. Primary outcome was the pCR rate. RESULTS: Twenty patients with clinical stage IB (n = 16), IIA (n = 1), IIB (n = 1), and IIIA (n = 2) were enrolled. Mean age was 65 years. Toxicity included grade 4 neutropenia in 1 (5%), grade 3 neutropenia in 3 (15%), grade 3 neuropathy in 1 (5%), and grade 3 nausea in 1 (5%). After neoadjuvant therapy, one patient refused surgery and one died of a nontreatment-related event. Eighteen patients underwent complete resection, 15 by lobectomy, and 3 by pneumonectomy. Pathology revealed 3 (17%) patients with pCR. The median follow-up is 67 months. For clinical stage IB (n = 16), the median overall survival has not been reached, and the 5-year overall survival is 69%. All patients with pCR (n = 3) remain alive and disease-free. Improved overall survival was seen in patients who were pathologically down-staged versus patients who were not, p = 0.05. CONCLUSIONS: Neoadjuvant chemotherapy with intensive weekly paclitaxel and carboplatin is well tolerated and does not increase surgical morbidity. This intense regimen achieves rates of pCR and survival that compares favorably with other reported induction regimens and merits further investigation.

Duke Scholars

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

August 2011

Volume

6

Issue

8

Start / End Page

1432 / 1434

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Remission Induction
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lung Neoplasms
 

Citation

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Ahmed, S., Birnbaum, A. E., Safran, H. P., Dipetrillo, T. A., Aswad, B. I., Ready, N. E., & Ng, T. (2011). Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study. J Thorac Oncol, 6(8), 1432–1434. https://doi.org/10.1097/JTO.0b013e3182209043
Ahmed, Shair, Ariel E. Birnbaum, Howard P. Safran, Thomas A. Dipetrillo, Bassam I. Aswad, Neal E. Ready, and Thomas Ng. “Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study.J Thorac Oncol 6, no. 8 (August 2011): 1432–34. https://doi.org/10.1097/JTO.0b013e3182209043.
Ahmed S, Birnbaum AE, Safran HP, Dipetrillo TA, Aswad BI, Ready NE, et al. Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study. J Thorac Oncol. 2011 Aug;6(8):1432–4.
Ahmed, Shair, et al. “Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study.J Thorac Oncol, vol. 6, no. 8, Aug. 2011, pp. 1432–34. Pubmed, doi:10.1097/JTO.0b013e3182209043.
Ahmed S, Birnbaum AE, Safran HP, Dipetrillo TA, Aswad BI, Ready NE, Ng T. Pathologic response after neoadjuvant carboplatin and weekly paclitaxel for early-stage lung cancer: a Brown University oncology group phase II study. J Thorac Oncol. 2011 Aug;6(8):1432–1434.
Journal cover image

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

August 2011

Volume

6

Issue

8

Start / End Page

1432 / 1434

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Remission Induction
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lung Neoplasms