Neoadjuvant Chemotherapy for Resectable Non–Small-Cell Lung Cancer

For patients with early stage IB–IIIA non–small-cell lung cancer (NSCLC), adjuvant chemotherapy has been proven to provide a 5% survival benefit at 5 years after surgical resection. To establish the role of neoadjuvant chemotherapy in this setting, international investigators conducted a meta-analysis of 15 international randomized trials with 2385 patients.

Preoperative chemotherapy conferred an absolute survival improvement of 5% at 5 years, which translates to a 13% reduction in relative risk for death and an improvement in overall survival (hazard ratio, 0.87; P=0.007. No subgroups realized greater benefit from neoadjuvant chemotherapy, and the choice or dose of chemotherapy or number of agents used did not affect survival. Recurrence-fr…