Survival correlation for low versus high enrolling institutions for patients with LA-NSCLC
Philadelphia, PA — Lung cancer is the leading cause of cancer-related death in the United States and is estimated to have contributed to 221,200 new cases and 158,040 deaths in 2015 alone. A secondary analysis of NRG Oncology's clinical trial RTOG 0617, published in the Journal of the National Cancer Institute, was initiated in an effort to evaluate the effect of institution accrual volume on clinical outcomes among patients receiving chemoradiation for locally advanced non-small cell lung cancer (LA-NSCLC). The study showed that patients treated at institutions with higher trial accrual volume on a phase III trial had statistically significant longer overall survival compared with patients treated at low-volume centers.
"The overall survival difference between patients treated at high-volume centers versus low-volume centers was greater than 10% at two years, which is a substantial finding for LA-NSCLC," says the study's lead author, Bree Eaton, MD of the Winship Cancer Institute of Emory University in Atlanta. "It is suspected that the effect on overall survival may be a reflection of both improved disease control and better management or prevention of adverse effects."
Four hundred and ninety-five eligible patients were randomly assigned and treated at 180 different institutions. The range of accrual for low-volume centers (LVCs) was one to three patients, whereas high-volume centers (HVCs) were four to 18 patients. RT was administered according to protocol specifications for target volume definition and treatment delivery. Kaplan-Meier (KM) estimates of overall survival at two years were 55.5 percent for the HVC cohort compared with 43.9 percent for the LVC cohort. HVC remained significantly associated with a lower risk of death.
"These results provide further clarification on the differences in outcomes between higher and lower accruing sites and it also shapes the way the radiation oncology community approaches the treatment of LA-NSCLC," says Walter J. Curran, Jr., MD, an NRG Oncology Group Chair and Executive Director of the Winship Cancer Institute of Emory University.
RTOG 0617 was funded by grants from the National Cancer Institute and Bristol-Myers Squibb
Institutional Enrollment and Survival Among NSCLC Patients Receiving Chemoradiation: NRG Oncology Radiation Therapy Group (RTOG) 0617 Bree R. Eaton; Stephanie L. Pugh; Jeffrey D. Bradley; Greg Masters; Vivek S. Kavadi; Samir Narayan; Lucien Nedzi; Cliff Robinson; Raymond B. Wynn; Christopher Koprowski; Douglas W. Johnson; Joanne Meng; Walter J. Curran, Jr. JNCI Journal of the National Cancer Institute 2016 108 (9): djw034 doi: 10.1093/jnci/djw034
NRG Oncology conducts practice-changing, multi-institutional clinical and translational research to improve the lives of patients with cancer. Founded in 2012, NRG Oncology is a Pennsylvania-based nonprofit corporation that integrates the research of the National Surgical Adjuvant Breast and Bowel Project, the Radiation Therapy Oncology Group, and the Gynecologic Oncology Group. The research organization seeks to carry out clinical trials with emphases on gender-specific malignancies, including gynecologic, breast, and prostate cancers, and on localized or locally advanced cancers of all types. NRG Oncology's extensive research organization comprises multidisciplinary investigators, including medical oncologists, radiation oncologists, surgeons, physicists, pathologists, and statisticians, and encompasses more than 1300 research sites located world-wide with predominance in the United States and Canada. NRG Oncology is supported primarily through grants from the National Cancer Institute (NCI) and is one of five research groups in the NCI's National Clinical Trials Network.