Which Chemotherapy with Radiation for Locally-Advanced Non–Small-Cell Lung Cancer?

For local-regional advanced non–small-cell lung cancer (NSCLC), curative intent chemoradiation yields 5-year overall survival rates of approximately 20% to 25%. Adjusting the systemic therapies in combination with radiation has been one strategy to improve clinical outcomes.

To compare the efficacy and safety of two such approaches, investigators conducted a randomized phase III trial (PROCLAIM), in which 555 patients with stage IIIA/B nonsquamous NSCLC received concurrent thoracic radiation (60–66 Gy) with either cisplatin plus pemetrexed followed by four cycles of pemetrexed consolidation or cisplatin plus etoposide followed by two cycles of consolidation non-pemetrexed platinum-doublet.

Enrollment was halted early due to futility. Medial o…