Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non-Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update
- PMID: 28437162
- DOI: 10.1200/JCO.2017.72.4401
Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non-Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update
Abstract
Purpose The panel updated the American Society of Clinical Oncology (ASCO) adjuvant therapy guideline for resected non-small-cell lung cancers. Methods ASCO convened an update panel and conducted a systematic review of the literature, investigating adjuvant therapy in resected non-small-cell lung cancers. Results The updated evidence base covered questions related to adjuvant systemic therapy and included a systematic review conducted by Cancer Care Ontario current to January 2016. A recent American Society for Radiation Oncology guideline and systematic review, previously endorsed by ASCO, was used as the basis for recommendations for adjuvant radiation therapy. An update of these systematic reviews and a search for studies related to radiation therapy found no additional randomized controlled trials. Recommendations Adjuvant cisplatin-based chemotherapy is recommended for routine use in patients with stage IIA, IIB, or IIIA disease who have undergone complete surgical resections. For individuals with stage IB, adjuvant cisplatin-based chemotherapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a medical oncologist, is recommended to assess benefits and risks of adjuvant chemotherapy for each patient. The guideline provides information on factors other than stage to consider when making a recommendation for adjuvant chemotherapy, including tumor size, histopathologic features, and genetic alterations. Adjuvant chemotherapy is not recommended for patients with stage IA disease. Adjuvant radiation therapy is not recommended for patients with resected stage I or II disease. In patients with stage IIIA N2 disease, adjuvant radiation therapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a radiation oncologist, is recommended to assess benefits and risks of adjuvant radiation therapy for each patient with N2 disease. Additional information is available at www.asco.org/lung-cancer-guidelines and www.asco.org/guidelineswiki .
Similar articles
-
A rapid and systematic review of the clinical effectiveness and cost-effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small-cell lung cancer.Health Technol Assess. 2001;5(32):1-195. doi: 10.3310/hta5320. Health Technol Assess. 2001. PMID: 12065068
-
A systematic overview of chemotherapy effects in colorectal cancer.Acta Oncol. 2001;40(2-3):282-308. doi: 10.1080/02841860151116367. Acta Oncol. 2001. PMID: 11441937
-
A systematic overview of chemotherapy effects in non-small cell lung cancer.Acta Oncol. 2001;40(2-3):327-39. doi: 10.1080/02841860151116402. Acta Oncol. 2001. PMID: 11441939
-
Postoperative Adjuvant Systemic Therapy in Completely Resected Non-Small-Cell Lung Cancer: A Systematic Review.Clin Lung Cancer. 2017 May;18(3):259-273.e8. doi: 10.1016/j.cllc.2016.07.002. Epub 2016 Jul 12. Clin Lung Cancer. 2017. PMID: 28162945
-
The effectiveness and cost-effectiveness of carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma: a systematic review and economic evaluation.Health Technol Assess. 2007 Nov;11(45):iii-iv, ix-221. doi: 10.3310/hta11450. Health Technol Assess. 2007. PMID: 17999840
Cited by
-
The role of EGFR-TKIs as adjuvant therapy in EGFR mutation-positive early-stage NSCLC: A meta-analysis.Thorac Cancer. 2021 Apr;12(7):1084-1095. doi: 10.1111/1759-7714.13874. Epub 2021 Mar 4. Thorac Cancer. 2021. PMID: 33660941 Free PMC article.
-
Impact of preoperative [18F]FDG PET/CT vs. contrast-enhanced CT in the staging and survival of patients with clinical stage I and II non-small cell lung cancer: a 10-year follow-up study.Ann Nucl Med. 2024 Mar;38(3):188-198. doi: 10.1007/s12149-023-01888-z. Epub 2023 Dec 25. Ann Nucl Med. 2024. PMID: 38145431
-
Adjuvant Osimertinib in Patients With Stage IB to IIIA EGFR Mutation-Positive NSCLC After Complete Tumor Resection: ADAURA China Subgroup Analysis.JTO Clin Res Rep. 2023 Dec 17;5(2):100621. doi: 10.1016/j.jtocrr.2023.100621. eCollection 2024 Feb. JTO Clin Res Rep. 2023. PMID: 38371194 Free PMC article.
-
Real-World Survival Outcomes Based on EGFR Mutation Status in Chinese Patients With Lung Adenocarcinoma After Complete Resection: Results From the ICAN Study.JTO Clin Res Rep. 2021 Nov 25;3(1):100257. doi: 10.1016/j.jtocrr.2021.100257. eCollection 2022 Jan. JTO Clin Res Rep. 2021. PMID: 34977823 Free PMC article.
-
Comparative Effectiveness of a Lymph Node Collection Kit Versus Heightened Awareness on Lung Cancer Surgery Quality and Outcomes.J Thorac Oncol. 2021 May;16(5):774-783. doi: 10.1016/j.jtho.2021.01.1618. Epub 2021 Feb 12. J Thorac Oncol. 2021. PMID: 33588112 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical