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Characteristics of toxicity occurrence patterns in concurrent chemoradiotherapy after induction chemotherapy for patients with locally advanced non-small cell lung cancer: a pooled analysis based on individual patient data of CALGB/Alliance trials.

Publication ,  Journal Article
Yang, LZ; He, Q; Zhang, J; Ganti, AK; Stinchcombe, TE; Pang, H; Wang, X
Published in: Transl Cancer Res
October 2022

BACKGROUND: For patients with locally advanced non-small cell lung cancer (NSCLC), concurrent chemoradiotherapy is the foundational treatment strategy. Adding induction chemotherapy did not achieve a superior efficacy but increased the burden from toxicity. Accordingly, we retrospectively investigated the toxicity patterns through pooling individual patient data of the Cancer and Leukemia Group B (CALGB)/Alliance trials. METHODS: We included a total of 637 patients with unresectable stage III NSCLC who received induction chemotherapy with a platinum doublet and concurrent chemoradiotherapy and experienced at least one adverse event (AE) in CALGB 9130, 9431, 9534, 30105, 30106 and 39801 trials. The following toxicity occurrence patterns were evaluated: top 10 most frequent AEs, AE distribution by grade, rate of treatment discontinuation due to AEs, associations of AE occurrence with patient characteristics and treatment phase, the time to the first grade ≥3 AE occurrence and its associations with patient characteristics and treatment phase. RESULTS: The occurrence of AEs was the main reason accounting for treatment discontinuation (60 of 637 among all patients; 18 of 112 patients who experienced the induction phase only; 42 of 525 patients who experienced both phases). All patients experienced a total of 11,786 AEs (grade ≥3: 1,049 of 5,538 in induction phase, 1,382 of 6,248 in concurrent phase). Lymphocytes and white blood count were of top 3 grade ≥3 AEs that patients experienced the most in the either phase. Multivariable analysis found AE occurrence was associated with age ≥65 [any grade: odds ratio (OR) =1.44, 95% confidence interval (CI): 1.12-1.86] and the concurrent phase (grade ≥3: OR =1.86, 95% CI: 1.41-2.47; any grade: OR =1.47, 95% CI: 1.19-1.81). Patients in the concurrent phase were more likely and earlier to develop grade ≥3 AEs than those in the induction phase [hazard ratio (HR) =4.37, 95% CI: 2.52-7.59]. CONCLUSIONS: The report provides a better understanding regarding the toxicity occurrence patterns in concurrent chemoradiotherapy after induction chemotherapy.

Duke Scholars

Published In

Transl Cancer Res

DOI

EISSN

2219-6803

Publication Date

October 2022

Volume

11

Issue

10

Start / End Page

3506 / 3521

Location

China

Related Subject Headings

  • 3211 Oncology and carcinogenesis
 

Citation

APA
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ICMJE
MLA
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Yang, L. Z., He, Q., Zhang, J., Ganti, A. K., Stinchcombe, T. E., Pang, H., & Wang, X. (2022). Characteristics of toxicity occurrence patterns in concurrent chemoradiotherapy after induction chemotherapy for patients with locally advanced non-small cell lung cancer: a pooled analysis based on individual patient data of CALGB/Alliance trials. Transl Cancer Res, 11(10), 3506–3521. https://doi.org/10.21037/tcr-22-2006
Yang, Lexie Zidanyue, Qihua He, Jianrong Zhang, Apar Kishor Ganti, Thomas E. Stinchcombe, Herbert Pang, and Xiaofei Wang. “Characteristics of toxicity occurrence patterns in concurrent chemoradiotherapy after induction chemotherapy for patients with locally advanced non-small cell lung cancer: a pooled analysis based on individual patient data of CALGB/Alliance trials.Transl Cancer Res 11, no. 10 (October 2022): 3506–21. https://doi.org/10.21037/tcr-22-2006.

Published In

Transl Cancer Res

DOI

EISSN

2219-6803

Publication Date

October 2022

Volume

11

Issue

10

Start / End Page

3506 / 3521

Location

China

Related Subject Headings

  • 3211 Oncology and carcinogenesis