A pooled exploratory analysis of the effect of tumor size and KRAS mutations on survival benefit from adjuvant platinum-based chemotherapy in node-negative non-small cell lung cancer.

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
Sinead CuffeFrances A Shepherd

Abstract

The staging of node-negative non-small-cell lung cancer is modified in the 7th edition TNM classification. Here, we pool data from the National Cancer Institute of Canada Clinical Trials Group JBR.10 trial and the Cancer and Leukemia Group B-9633 trial to explore the prognostic and predictive effects of the new T-size descriptors and KRAS mutation status. Node-negative patients were reclassified as T2a (>3-≤5 cm), T2b (>5-≤7 cm), T3 (>7 cm) or T ≤ 3 cm (≤3 cm, but other T2 characteristics). Of 538 eligible patients, 288 (53.5%) were T2a, 111 (21%) T2b, 62 (11.5%) T3, whereas 77 (14%) T≤3 cm were excluded to avoid confounding. KRAS mutations were detected in 104 of 390 patients (27%). T-size was prognostic for disease-free survival (p = 0.03), but borderline for overall survival (OS; p = 0.10), on multivariable analysis. Significant interaction between the prognostic value of KRAS and tumor size was observed for OS (p = 0.01), but not disease-free survival (p = 0.10). There was a nonsignificant trend (p = 0.24) for increased chemotherapy effect on OS with advancing T-size (hazard ratio [HR] T2a 0.90, [0.63-1.30]; T2b 0.69, [0.38-1.24]; and T3 0.57, [0.28-1.17]). The HR for chemotherapy effect on OS in T2a patients with KRAS wild...Continue Reading

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Citations

Apr 22, 2014·The Journal of Thoracic and Cardiovascular Surgery·Bo DengPing Yang
Apr 24, 2013·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Daquan MengJianbao Xin
Jun 5, 2016·Surgical Oncology Clinics of North America·Evan C Naylor
Feb 13, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Peter Goldstraw
Jan 1, 2012·Journal of Personalized Medicine·David E Dawe, Peter M Ellis
Mar 9, 2021·The Annals of Thoracic Surgery·Andrew X LiJustin D Blasberg
Sep 1, 2013·EJC Supplements : EJC : Official Journal of EORTC, European Organization for Research and Treatment of Cancer ... [et Al.]·Jan P van Meerbeeck, Annelies Janssens

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