A randomised trial comparing preoperative to perioperative chemotherapy in early-stage non-small-cell lung cancer (IFCT 0002 trial)

A randomised trial comparing preoperative to perioperative chemotherapy in early-stage non-small-cell lung cancer (IFCT 0002 trial) - Corrected Proof surgery remains best treatment option for early stage NSCLC. However there is still risk and local failure due to micrometastatic disease. Thus adding chemotherapy pre or post surgery may offer benefits. Based on other studies, this study hypothesis was adding neo-adj chemo will increase OS. open-label, 2 × 2 factorial randomised trial in patients with clinical Stage I (including T1N0) or II resectable NSCLC compared chemo regimes - 1 ) 2 cycles pre, then assess patient for repsonce then if good repsonse continue for 2 more cycles 2) pre cycles pre op, two cycles post op these two arms were then split into two hands 1) testing regime gemcitabine/cisplatin (GP), vs 2)paclitaxel/carboplatin (TC) end point were OS, DFS plus measure of QoL. All four groups seem to be split with equal variation across. results- overall, no diff between full neo adjvant and the pre and post chemo group. QoL slightly better in the neo adjuvant group. "The results of this randomised trial showed that the delivery of four cycles of preoperative chemotherapy in responders did not increase survival when compared with two preoperative plus two postoperative cycles in Stage I and II NSCLC. There was also no difference in survival between the two chemotherapy regimens, GP and TC" reasons cited for non results- inc stage 1 disease which there is little data to ponder as regards to adding chemo to surgery.Also many of the pre op arm were non responders thus did not recive all four cycles Study suggests clearer guidelines for the treatment of early stage NSCLC (i.e. adding chemo) " It has been shown that only a certain proportion of patients benefit from adjuvant cisplatin-based chemotherapy" EJC 2013