What regimen should be used?
Most studies used a platinum based two-drug combination administered in three to four cycles.1No trials have compared different adjuvant chemotherapy regimens but based on the meta-analysis, it appears there are no significant differences between regimens. The Lung Adjuvant Cisplatin Evaluation (LACE) meta-analysis, which included only modern cisplatin-based regimens, confirmed the survival benefits of adjuvant cisplatin (HR 0.89; 95% CI, 0.82- 0.96; P=0.005) with 5-year absolute benefit of 5.4% from chemotherapy.3All five guidelines have addressed the issue on what adjuvant chemotherapy regimen should be used. (Supplemental Table 1)
Recommendations on Adjuvant Chemotherapy Regimen
Following discussion and consensus, the workgroup is in favour of adopting the CCCALCGWP Guidelines (Table 1).
Recommendations are as follows:
Patients with completely resected stage II NSCLC should be offered 3-4 cycles of adjuvant cisplatin based chemotherapy (A).
Patients who have a good performance status (WHO 1, 2) and completely resected stage III NSCLC should be offered adjuvant cisplatin-based chemotherapy (A).