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Confirmed that chemotherapy after lung cancer surgery adds about two years to median survival, with the benefit lasting at least seven years.
ANITA randomised 840 patients with completely resected stage IB to IIIA non-small-cell lung cancer from 101 centres in 14 countries to observation (433) or to vinorelbine 30 mg/m2 with cisplatin 100 mg/m2 (407). Postoperative radiotherapy was not mandated and followed each centre's policy. Thirty-six percent had stage IB disease, 24 percent stage II and 39 percent stage IIIA.
After a median 76 months, median survival was 65.7 months with chemotherapy against 43.7 months with observation, and the adjusted hazard ratio for death was 0.80 (95 percent confidence interval 0.66 to 0.96, p=0.017). Five-year overall survival improved by 8.6 percent and the gain was maintained at seven years (8.4 percent).
Tolerance was the limiting factor: neutropenia in 92 percent, febrile neutropenia in 9 percent and seven toxic deaths (2 percent), with compliance far better for cisplatin (median dose intensity 89 percent) than for vinorelbine (59 percent). A retrospective subgroup suggested postoperative radiotherapy helped N2 patients, a hypothesis Lung ART later tested and refuted.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
840 randomised.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival (median)primary | Vinorelbine and cisplatin | 407 | 65.7 months | 0.8 (0.66 to 0.96) | 0.017 | link |
| Observation | 433 | 43.7 months |
Shares Vinorelbine, Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents.
Shares Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents, Cytotoxic chemotherapy.
Shares Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents, Cytotoxic chemotherapy.
Shares Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents, Cytotoxic chemotherapy.
Shares Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents, Cytotoxic chemotherapy.
Shares Vinorelbine, Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents.
Shares Vinorelbine, Cisplatin, Lung cancer (all types).
Shares Resectable stage I to III non-small-cell lung cancer, Cisplatin, Platinum agents, Cytotoxic chemotherapy.