Pattern of care in adjuvant therapy for resected Stage I non-small cell lung cancer: Real-world data from Japan

Kiyotaka Yoh, Kazuya Takamochi, Takehito Shukuya, Tomoyuki Hishida, Masahiro Tsuboi, Hiroyuki Sakurai, Yasushi Goto, Koichi Yoshida, Yasuhisa Ohde, Sakae Okumura, Yasuo Ohashi, Hideo Kunitoh

Research output: Contribution to journalArticle

Abstract

Background: Adjuvant tegafur/uracil (UFT) chemotherapy is recommended for patients with completely resected Stage I non-small cell lung cancer (NSCLC) in Japan. A Phase III trial, the Japan Clinical Oncology Group (JCOG) 0707, comparing the survival benefit of UFT and S-1 (tegafur/gimeracil/oteracil) for this population is being conducted. However, the selection of patients in the randomized clinical trial (RCT) may not represent the real-world population. The present study aimed to investigate the pattern of care for patients receiving adjuvant chemotherapy for completely resected NSCLC. Methods: Patients with completely resected pathological Stage I (T1 > 2 cm and T2 in 6th TNM edition) NSCLC eligible for the JCOG0707 trial but excluded from it during the enrollment period (2008–13) were eligible for this study. Physicians from institutions that participated in the JCOG0707 retrospectively assessed the medical records of each patient. Results: This study enrolled 5006 patients, 85% of those initially considered for participation in the JCOG0707 trial (5006 of 5923 patients). Among them, 2389 were ineligible for the trial and 2617 had not been enrolled despite being eligible. The most frequent reason for non-enrollment despite eligibility was the decline in patients’ participation, and the major reasons for trial ineligibility were concomitant malignancy and comorbidities. Of all the patients enrolled in our study, 1659 received adjuvant chemotherapy, mainly UFT. Conclusions: Our study indicates that only 15% of the real-world patients with completely resected NSCLC were enrolled into the adjuvant chemotherapy RCT, and among those not participating in the trial, one-third received adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalJapanese journal of clinical oncology
Volume49
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • Adjuvant chemotherapy
  • Non-small cell lung cancer
  • Randomized clinical trial
  • Real-world study
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Yoh, K., Takamochi, K., Shukuya, T., Hishida, T., Tsuboi, M., Sakurai, H., Goto, Y., Yoshida, K., Ohde, Y., Okumura, S., Ohashi, Y., & Kunitoh, H. (2019). Pattern of care in adjuvant therapy for resected Stage I non-small cell lung cancer: Real-world data from Japan. Japanese journal of clinical oncology, 49(1), 63-68. https://doi.org/10.1093/jjco/hyy165