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. 2020 Nov 13;12(11):3359.
doi: 10.3390/cancers12113359.

Efficacy and Toxicity of Different Chemotherapy Protocols for Concurrent Chemoradiation in Non-Small Cell Lung Cancer-A Secondary Analysis of the PET Plan Trial

Eleni Gkika  1   2   3 , Stefan Lenz  4 , Tanja Schimek-Jasch  1   2 , Cornelius F Waller  3   5 , Stephanie Kremp  6 , Andrea Schaefer-Schuler  7 , Michael Mix  3   8 , Andreas Küsters  9 , Marco Tosch  10   11 , Thomas Hehr  12 , Susanne Martina Eschmann  13 , Yves-Pierre Bultel  14 , Peter Hass  15 , Jochen Fleckenstein  6 , Alexander Henry Thieme  16 , Marcus Stockinger  17 , Karin Dieckmann  18 , Matthias Miederer  19 , Gabriele Holl  20 , Hans Christian Rischke  1   3   8 , Sonja Adebahr  1   2 , Jochem König  21 , Harald Binder  4 , Anca-Ligia Grosu  1   2   3 , Ursula Nestle  1   2   3   9
Affiliations

Efficacy and Toxicity of Different Chemotherapy Protocols for Concurrent Chemoradiation in Non-Small Cell Lung Cancer-A Secondary Analysis of the PET Plan Trial

Eleni Gkika et al. Cancers (Basel). .

Abstract

(1) Background: The optimal chemotherapy (CHT) regimen for concurrent chemoradiation (cCRT) is not well defined. In this secondary analysis of the international randomized PET-Plan trial, we evaluate the efficacy of different CHT. (2) Methods: Patients with inoperable NSCLC were randomized at a 1:1 ratio regarding the target volume definition and received isotoxically dose-escalated cCRT using cisplatin 80 mg/m2 (day 1, 22) and vinorelbin 15 mg/m2 (day 1, 8, 22, 29) (P1) or cisplatin 20 mg/m2 (day 1-5, 29-33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P2) or carboplatin AUC1 (day 1-5, 29-33) and vinorelbin 12.5 mg/m2 (day 1, 8, 15, 29, 36, 43) (P3) or other CHT at the treating physician's discretion. (3) Results: Between 05/2009 and 11/2016, 205 patients were randomized and 172 included in the per-protocol analysis. Patients treated in P1 or P2 had a better overall survival (OS) compared to P3 (p = 0.015, p = 0.01, respectively). Patients treated with carboplatin had a worse OS compared to cisplatin (HR 1.78, p = 0.03), but the difference did not remain significant after adjusting for age, ECOG, cardiac function creatinine and completeness of CHT. (4) Conclusions: Carboplatin doublets show no significant difference compared to cisplatin, after adjusting for possibly relevant factors, probably due to existing selection bias.

Keywords: NSCLC; chemoradiotherapy; concomitant chemoradiation; non-small cell lung cancer.

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Conflict of interest statement

SA receives fees from the German cancer consortium, CW received fees from Mylan Inc. Alvotech, Roche, AstraZeneca, Boehringer Ingelheim, BMS, Chugai, Pfizer, Takeda, IPSEN, Lilly. All other authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Overall survival according to different chemotherapy protocols.
Figure 2
Figure 2
Overall survival of patients with cisplatin vs. carboplatin-based protocols.
Figure 3
Figure 3
Overall survival of patients treated according to institutional standard vs. non-standard chemotherapy protocols.
See this image and copyright information in PMC

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