Adjuvant systemic therapy and adjuvant radiation therapy for stage I to IIIA completely resected non-small-cell lung cancers: American Society of Clinical Oncology/Cancer Care Ontario clinical practice guideline update Journal Article


Authors: Kris, M. G.; Gaspar, L. E.; Chaft, J. E.; Kennedy, E. B.; Azzoli, C. G.; Ellis, P. M.; Lin, S. H.; Pass, H. I.; Seth, R.; Shepherd, F. A.; Spigel, D. R.; Strawn, J. R.; Ung, Y. C.; Weyant, M.
Article Title: Adjuvant systemic therapy and adjuvant radiation therapy for stage I to IIIA completely resected non-small-cell lung cancers: American Society of Clinical Oncology/Cancer Care Ontario clinical practice guideline update
Abstract: Purpose: The panel updated the American Society of Clinical Oncology (ASCO) adjuvant therapy guideline for resected non-small-cell lung cancers. Methods: ASCO convened an update panel and conducted a systematic review of the literature, investigating adjuvant therapy in resected non-small-cell lung cancers. Results: The updated evidence base covered questions related to adjuvant systemic therapy and included a systematic review conducted by Cancer Care Ontario current to January 2016. A recent American Society for Radiation Oncology guideline and systematic review, previously endorsed by ASCO, was used as the basis for recommendations for adjuvant radiation therapy. An update of these systematic reviews and a search for studies related to radiation therapy found no additional randomized controlled trials. Recommendations: Adjuvant cisplatin-based chemotherapy is recommended for routine use in patients with stage IIA, IIB, or IIIA disease who have undergone complete surgical resections. For individuals with stage IB, adjuvant cisplatin-based chemotherapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a medical oncologist, is recommended to assess benefits and risks of adjuvant chemotherapy for each patient. The guideline provides information on factors other than stage to consider when making a recommendation for adjuvant chemotherapy, including tumor size, histopathologic features, and genetic alterations. Adjuvant chemotherapy is not recommended for patients with stage IA disease. Adjuvant radiation therapy is not recommended for patients with resected stage I or II disease. In patients with stage IIIA N2 disease, adjuvant radiation therapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a radiation oncologist, is recommended to assess benefits and risks of adjuvant radiation therapy for each patient with N2 disease. Additional information is available at www.asco.org/lung-cancer-guidelines and www.asco.org/guidelineswiki. © 2017 by American Society of Clinical Oncology.
Keywords: cancer chemotherapy; medical oncologist; cancer surgery; clinical feature; histopathology; neutropenia; postoperative period; cisplatin; multimodality cancer therapy; systemic therapy; adjuvant therapy; cancer adjuvant therapy; cancer patient; cancer radiotherapy; chemotherapy, adjuvant; radiotherapy, adjuvant; cancer staging; antineoplastic agent; neoplasm staging; clinical practice; tumor volume; esophagitis; antineoplastic combined chemotherapy protocols; carcinoma, non-small-cell lung; lung neoplasms; practice guideline; pathology; oncology; dysphagia; odynophagia; cancer center; radiation oncology; systematic review; adjuvant chemotherapy; medical oncology; consultation; phase 3 clinical trial; second cancer; adjuvant radiotherapy; standards; non small cell lung cancer; randomized controlled trial (topic); procedures; surgical oncology; humans; human; priority journal; article; radiation oncologist
Journal Title: Journal of Clinical Oncology
Volume: 35
Issue: 25
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2017-09-01
Start Page: 2960
End Page: 2974
Language: English
DOI: 10.1200/jco.2017.72.4401
PUBMED: 28437162
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 2 October 2017 -- Source: Scopus
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MSK Authors
  1. Jamie Erin Chaft
    136 Chaft
  2. Mark Kris
    629 Kris