非小细胞肺癌辅助化疗治疗中循证的重要性从迷雾重重到云开雾散精品文档课件.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * In order to give a clear conclusion on the treatment of completely resected patients, a meta-analysis on all the CDDP-based chemotherapies used in adjuvant was conducted, and the results presented this year at ASCO. * * * The LACE meta-analysis confirms the significant impact of adjuvant chemotherapy on survival. NB: The Big Lung Trial (BLT) is a study from Great Britain examining the role of cisplatin-based chemotherapy in a variety of treatment settings in patients with NSCLC. Among these, patients with completely resected stage I-III NSCLC were randomly assigned to three cycles of pre- (4%) or postoperative (96%) cisplatin-based chemotherapy or surgery alone. Note that this trial was not designed to specifically answer a surgical adjuvant question and is thus underpowered to detect a clinically significant survival difference.Its individual data were considered inside LACE meta-analysis. * * * The absolute survival benefit at 5 years is greater than 5%. * * * What should be the drug associated to cisplatin? Of the different chemotherapy regimens present in this meta-analysis, the effect of the combination of NAVELBINE + Cisplatin is better than the others. * * * The LACE meta-analysis confirms what appeared in ANITA trial: patients that benefit the most from adjuvant CDDP-based chemotherapy are stage II and III, to a lesser extent stage IB. * * * * * This meta-analysis concludes on the efficacy of CDDP-based combinations in that setting, NVB is the only drug with real experience in that setting and it works Patients with stage II and III are truly candidates for adjuvant chemotherapy. * * ASCO07 NSCLC Neo/Adj – PFO MA NSCLC 辅助化疗Meta分析: MRC 汇集辅助化疗进行 Meta-分析(Stewart#P7552) 绝对获益 绝对改变 VS 基线 2 YEARS 2% (1%-3%) 80%-82% 5 YEARS 4% (2%-4%) 60%-64% 8 YEARS 5% (2 %-7%) 50%-55% 5年生存率提高4％相当于死亡率降低13％ ASCO07 NSCLC Neo/Adj – PFO MA 结果 HR (95% CI)