{"entity":{"id":"ialt","kind":"trial","name":"IALT (International Adjuvant Lung Cancer Trial)","aka":["International Adjuvant Lung Cancer Trial"],"tldr":"The first large trial to show that chemotherapy after lung cancer surgery helps people live longer, though the gain is a few percent rather than a transformation.","summary":"IALT randomised 1,867 patients with completely resected non-small-cell lung cancer to three or four cycles of cisplatin-based chemotherapy or to observation. Each centre chose the partner drug and its own postoperative radiotherapy policy, so the trial is a test of the strategy rather than of a regimen: etoposide was used in 56.5 percent, vinorelbine in 26.8 percent, vinblastine in 11.0 percent and vindesine in 5.8 percent. Pathological stage was I in 36.5 percent, II in 24.2 percent and III in 39.3 percent.\n\nAt a median 56 months, five-year survival was 44.5 percent with chemotherapy against 40.4 percent with observation (469 against 504 deaths, hazard ratio for death 0.86, 95 percent confidence interval 0.76 to 0.98). Three-quarters of the chemotherapy arm received at least 240 mg/m2 of cisplatin.\n\nIALT is the trial that made adjuvant chemotherapy the standard, and its size is the reason the four-to-five percent absolute benefit is believed. Later follow-up weakened the survival difference, which is part of why the LACE pooled analysis was done.","status":"positive","asOf":"2026-09-25","links":[{"label":"IALT (New England Journal of Medicine 2004)","url":"https://doi.org/10.1056/NEJMoa031644"}],"tags":[],"related":[],"cancers":["resectable-nsclc"],"sections":[],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["cisplatin","etoposide","vinorelbine"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["jbr-10","anita","lace-pooled-analysis"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Completely resected non-small-cell lung cancer, any stage I to III: three or four cycles of cisplatin-based chemotherapy versus observation, with overall survival as the primary endpoint","sponsor":"Institut Gustave Roussy and the IALT Collaborative Group","result":"Five-year survival 44.5 against 40.4 percent (hazard ratio for death 0.86).","yearReported":2004,"enrolled":1867,"enrolledBasis":"randomised","enrolledNote":"1,867 patients were randomised; the trial predates ClinicalTrials.gov registration, so there is no registry figure.","outcomes":[{"endpoint":"Overall survival at 5 years","primary":true,"unit":"%","arms":[{"name":"Cisplatin-based chemotherapy","n":932,"value":44.5},{"name":"Observation","n":935,"value":40.4}],"hr":0.86,"ci":[0.76,0.98],"source":"https://doi.org/10.1056/NEJMoa031644"}],"replication":"JBR.10 and ANITA reproduced the benefit with cisplatin and vinorelbine; the LACE pooled analysis of 4,584 patients from the five largest trials confirmed it."},"route":"/trials/ialt/","neighbours":{"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"resectable-nsclc","kind":"cancer","name":"Resectable stage I to III non-small-cell lung cancer","route":"/cancers/resectable-nsclc/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"vinorelbine","kind":"drug","name":"Vinorelbine","route":"/drugs/vinorelbine/"}],"trial":[{"id":"adaura","kind":"trial","name":"ADAURA","route":"/trials/adaura/"},{"id":"anita","kind":"trial","name":"ANITA (Adjuvant Navelbine International Trialist Association)","route":"/trials/anita/"},{"id":"jbr-10","kind":"trial","name":"JBR.10 (NCIC CTG)","route":"/trials/jbr-10/"},{"id":"lace-pooled-analysis","kind":"trial","name":"LACE (Lung Adjuvant Cisplatin Evaluation) pooled analysis","route":"/trials/lace-pooled-analysis/"}]}}