A randomized phase 3 study of maintenance therapy with S-1 plus best supportive care versus best supportive care after induction therapy with carboplatin plus S-1 for advanced or relapsed squamous cell carcinoma of the lung (WJOG7512L)
Mené sur 365 patients atteints d’un cancer épidermoïde du poumon non à petites cellules de stade avancé ou récidivant, cet essai de phase III évalue l’efficacité, du point de vue de la survie sans progression, et la toxicité de l’ajout de S-1 aux "meilleurs soins de support" en traitement d’entretien, après une thérapie d’induction à base de S-1 et de carboplatine
Background : A randomized phase 3 study was performed to investigate the efficacy and safety of maintenance therapy with S?1 after induction therapy with carboplatin plus S?1 in patients with advanced squamous non–small cell lung cancer (NSCLC). Methods : Chemotherapy?naive patients with advanced or relapsed squamous NSCLC were treated with carboplatin (area under the curve of 5 on day 1 every 3 weeks) plus S?1 (40 mg/m2 twice per day on days 1?14 every 3 weeks) as induction therapy. Patients who did not progress after 4 cycles of induction therapy were randomized to receive either S?1 plus best supportive care (BSC) or BSC alone. The primary objective of the study was to confirm the superiority of S?1 plus BSC in comparison with BSC alone with respect to progression?free survival. Results : Of the 365 patients enrolled in the study, 347 participated in the induction phase, and 131 of these individuals were randomized to receive S?1 plus BSC (n = 67) or BSC alone (n = 64). The risk of disease progression was significantly lower for patients in the S?1 plus BSC arm than those in the BSC?alone arm (hazard ratio, 0.548; 95% confidence interval, 0.374?0.802; P = .0019). The most common toxicities during maintenance therapy with S?1 included anorexia, anemia, and fatigue, but most cases were not severe. Conclusions : Continued maintenance with S?1 plus BSC is an effective and well?tolerated treatment option for patients with advanced squamous NSCLC previously treated with carboplatin plus S?1.