Lung Cancer Study Questioned

Lung cancer therapy analysis found wanting

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) What happens when researchers disagree? That's the nature of good research - disagreeing and challenging before coming to consensus. A recent lung cancer study is being debated.

A small study conducted in France found that people with two types of lung cancer -- limited stage small-cell lung cancer (SCLC) and large-cell neuroendocrine carcinoma (LCNEC) -- live longer if they receive chemotherapy before surgery.

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dailyRx Contributing Expert and leading lung cancer researcher, D. Ross Camidge, MD, PhD, director of the lung cancer clinical program at University of Colorado Hospital (UCH), isn't impressed.

"These studies raise more questions than answers," he tells dailyRx in an email.

The retrospective study involved 74 patients who had undergone lung cancer surgery at the Surgical Centre Marie Lannelongue in Le Plessis Robinson, France between 1979 and 2007.

Of this group, 45 people had chemotherapy before surgery, and 29 had only surgery.

"Surgery for small cell is rarely conducted -- a combination of chemotherapy and radiation therapy is more commonly used, which was not compared with the surgical approach here," Dr. Camidge points out.

Researchers found that people who received the pre-operative chemotherapy lived just over six years, nearly three times longer than those who had only surgery -- who lived a little over two years after treatment.

There were limitations to this study, the authors admit, including the fact that a different cancer staging system was used in 1979 at the start of the study, a point Dr. Camidge noticed.

"The series covers so many years the accuracy of staging in the earlier cases has to be suspect compared to the later cases," he said.

The authors also said, "more patients had a node involvement in the chemotherapy group, indicating that physicians may have offered chemotherapy to patients with more advanced disease."

In the end, the authors say no conclusion was drawn, because of the, "small population examined in this study, its retrospective nature, the difference in follow-up between the two groups and the heterogeneity of the combined treatments." They don't believe prospective studies will be conducted due to the small size of this patient population.

This study was published in the July 2012 issue of the International Association for the Study of Lung Cancer's (IASLC) Journal of Thoracic Oncology

Reviewed by: 
Review Date: 
June 20, 2012
Last Updated:
June 20, 2012