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Sequence of biologic therapies and surgery affects survival in non–small cell lung cancer
Author(s) -
Xu Edison,
David Elizabeth A.,
Ding Li,
Atay Scott M.,
McFadden Paul M.,
Wightman Sean C.,
Kim Anthony W.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25937
Subject(s) - medicine , oncology , neoadjuvant therapy , adjuvant therapy , lung cancer , chemotherapy , adjuvant , proportional hazards model , cancer , surgery , breast cancer
Abstract Background and Objectives Biologic therapy is changing the landscape of lung cancer treatment. The objectives of this study were to compare overall survival (OS) between patients with non–small cell lung cancer (NSCLC) undergoing neoadjuvant and adjuvant biologic therapy in combination with surgery and to evaluate the impact of chemotherapy on survival after combination biologic therapy and surgery. Methods The National Cancer Database was queried for cases of NSCLC from 2004 to 2016. Patient treatment was categorized into neoadjuvant and adjuvant biologic therapy in combination with surgery. Kaplan‐Meier curves were generated to compare OS between treatment groups and between those who did and did not also undergo chemotherapy. Cox regression was used to identify factors predictive of OS. Results Six hundred seventy‐three patients underwent both biologic therapy and surgery. The unadjusted overall 5‐year OS was longer for patients undergoing neoadjuvant biologic therapy than for those undergoing adjuvant biologic therapy ( P = .006), with OS being 56.2% and 33.0%, respectively. When comparing OS between those who did and did not undergo additional chemotherapy, no difference was observed. Conclusions Neoadjuvant biologic therapy was associated with longer OS than adjuvant biologic therapy. Chemotherapy did not have an effect on OS when combined with biologic therapy and surgery.