Monday, July 2, 2012

Carbo + RT in the elderly with NSCLC

In the Lancet Oncology this week:

A Phase III trial from Japan is reported, showing a survival benefit with the addition of a modest dose of carboplatin with Thoracic RT.  What I think is perhaps most interesting in this trial lies in the introduction: A prior JCOG study was halted prematurely due to excess deaths in the carbo arm - turns out that much of the toxicity related to poor radiotherapy design.  With more stringent QA, this trial was conceived and executed - now demonstrating a significant effect.  I would find this as cautionary tale for trial design moving forward - treatment escalation is well and good, but needs to be very carefully.


[Articles] Thoracic radiotherapy with or without daily low-dose carboplatin in elderly patients with non-small-cell lung cancer: a randomised, controlled, phase 3 trial by the Japan Clinical Oncology Group (JCOG0301): For a select group of elderly patients with locally advanced NSCLC, combination chemoradiotherapy provides a clinically significant benefit over radiotherapy alone, and should be considered for this population.

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