# LACE (Lung Adjuvant Cisplatin Evaluation) pooled analysis

Source: https://onco.cc/trials/lace-pooled-analysis/  
OnCo record `lace-pooled-analysis` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pooling five trials settled the question of who benefits from chemotherapy after lung cancer surgery: about five people in a hundred live longer at five years, and none of them has stage IA disease.

## Summary

LACE pooled individual patient data on 4,584 patients from the five largest trials of cisplatin-based chemotherapy after complete resection conducted after the 1995 non-small-cell lung cancer meta-analysis. At a median 5.2 years, the overall hazard ratio for death was 0.89 (95 percent confidence interval 0.82 to 0.96, p=0.005), a 5.4 percent absolute five-year benefit, with no heterogeneity between trials.

The benefit varied by stage (test for trend p=0.04): stage IA hazard ratio 1.40 (0.95 to 2.06), stage IB 0.93 (0.78 to 1.10), stage II 0.83 (0.73 to 0.95) and stage III 0.83 (0.72 to 0.94). Chemotherapy in stage IA disease looked harmful, and it has not been offered since. The drug partner did not significantly change the effect, although vinorelbine gave the numerically best hazard ratio (0.80, 0.70 to 0.91) against etoposide or a vinca alkaloid (0.92) and other partners (0.97). Benefit was larger in patients with better performance status, and did not vary by sex, age, histology, type of surgery, planned radiotherapy or planned cisplatin dose.

LACE is the reference that decides who is offered adjuvant chemotherapy today, and its stage gradient is the reason a 3 cm node-negative tumour is treated differently from a 5 cm one.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-25
- Also known as: LACE meta-analysis; Lung Adjuvant Cisplatin Evaluation
- Phase: observational
- Setting: Individual patient data from the five largest trials of postoperative cisplatin-based chemotherapy in completely resected non-small-cell lung cancer, analysed for interactions between chemotherapy effect and stage, drug partner and performance status
- Sponsor: LACE Collaborative Group
- Enrolled: 4584
- Result: Hazard ratio for death 0.89 (95 percent confidence interval 0.82 to 0.96), a 5.4 percent absolute five-year survival benefit; no benefit, and possible harm, in stage IA.
- Outcomes: Overall survival, all stages: Cisplatin-based adjuvant chemotherapy, HR 0.89; Overall survival, stage IA: Cisplatin-based adjuvant chemotherapy, HR 1.4; Overall survival, stage II: Cisplatin-based adjuvant chemotherapy, HR 0.83

## Sources

- LACE pooled analysis (Journal of Clinical Oncology 2008): https://doi.org/10.1200/JCO.2007.13.9030

## Connected records

- cancers: [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Resectable stage I to III non-small-cell lung cancer](https://onco.cc/cancers/resectable-nsclc/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Platinum agents](https://onco.cc/technologies/platinum/)
- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Vinorelbine](https://onco.cc/drugs/vinorelbine/)
- terms: [Performance status (ECOG, Karnofsky)](https://onco.cc/terms/performance-status/)
- trials: [ADAURA](https://onco.cc/trials/adaura/), [ANITA (Adjuvant Navelbine International Trialist Association)](https://onco.cc/trials/anita/), [IALT (International Adjuvant Lung Cancer Trial)](https://onco.cc/trials/ialt/), [JBR.10 (NCIC CTG)](https://onco.cc/trials/jbr-10/)

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