LACE: trial | Bending the Curve: Trial by Trial

LACE

Needs review

Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group

Phase meta-analysisN = 4,584

Population

Completely resected non-small-cell lung cancer, patients pooled from five trials of postoperative cisplatin-based chemotherapy.

Design

Pooled analysis of individual patient data from the five largest trials (4584 patients) of cisplatin-based chemotherapy in completely resected patients that were conducted after the 1995 NSCLC meta-analysis. Interactions between patient subgroups or treatment types and the chemotherapy effect on overall survival were analysed with hazard ratios and log-rank tests stratified by trial. The trials pooled are not named in the abstract.

Primary endpoint

Arms

No postoperative chemotherapy (control): Control arms of the pooled trials
Cisplatin-based chemotherapy (experimental): Postoperative cisplatin-based chemotherapy as given in the pooled trials

People

Pignon JP, LACE Collaborative Group

OSHR 0.89 (95% CI 0.82–0.96)OSHR 1.40 (95% CI 0.95–2.06)OSHR 0.93 (95% CI 0.78–1.10)OSHR 0.83 (95% CI 0.73–0.95)OSHR 0.83 (95% CI 0.72–0.94)OSHR 0.80 (95% CI 0.70–0.91)

Show the numbers

Results reported for LACE
Endpoint	Analysis	Cisplatin-based chemotherapy	No postoperative chemotherapy	Effect
OSAll pooled patients (4584)	primarymedian follow-up 5.2 yearsPignon 2008	—	—	HR 0.89 (95% CI 0.82–0.96)P=.005The abstract reports a 5-year absolute benefit of 5.4% from chemotherapy and no heterogeneity of the chemotherapy effect among trials. Median follow-up 5.2 years.
OSStage IA subgroup	exploratoryPignon 2008	—	—	HR 1.40 (95% CI 0.95–2.06)Benefit varied with stage (test for trend P = .04).
OSStage IB subgroup	exploratoryPignon 2008	—	—	HR 0.93 (95% CI 0.78–1.10)Benefit varied with stage (test for trend P = .04).
OSStage II subgroup	exploratoryPignon 2008	—	—	HR 0.83 (95% CI 0.73–0.95)Benefit varied with stage (test for trend P = .04).
OSStage III subgroup	exploratoryPignon 2008	—	—	HR 0.83 (95% CI 0.72–0.94)Benefit varied with stage (test for trend P = .04).
OSVinorelbine-containing regimens subgroup	exploratoryPignon 2008	—	—	HR 0.80 (95% CI 0.70–0.91)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).
OSEtoposide or vinca alkaloid regimens subgroup	exploratoryPignon 2008	—	—	HR 0.92 (95% CI 0.80–1.07)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).
OSOther associated drugs subgroup	exploratoryPignon 2008	—	—	HR 0.97 (95% CI 0.84–1.13)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).

Results reported for LACE
Endpoint	Analysis	Cisplatin-based chemotherapy	No postoperative chemotherapy	Effect
OSAll pooled patients (4584)	primarymedian follow-up 5.2 yearsPignon 2008	—	—	HR 0.89 (95% CI 0.82–0.96)P=.005The abstract reports a 5-year absolute benefit of 5.4% from chemotherapy and no heterogeneity of the chemotherapy effect among trials. Median follow-up 5.2 years.
OSStage IA subgroup	exploratoryPignon 2008	—	—	HR 1.40 (95% CI 0.95–2.06)Benefit varied with stage (test for trend P = .04).
OSStage IB subgroup	exploratoryPignon 2008	—	—	HR 0.93 (95% CI 0.78–1.10)Benefit varied with stage (test for trend P = .04).
OSStage II subgroup	exploratoryPignon 2008	—	—	HR 0.83 (95% CI 0.73–0.95)Benefit varied with stage (test for trend P = .04).
OSStage III subgroup	exploratoryPignon 2008	—	—	HR 0.83 (95% CI 0.72–0.94)Benefit varied with stage (test for trend P = .04).
OSVinorelbine-containing regimens subgroup	exploratoryPignon 2008	—	—	HR 0.80 (95% CI 0.70–0.91)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).
OSEtoposide or vinca alkaloid regimens subgroup	exploratoryPignon 2008	—	—	HR 0.92 (95% CI 0.80–1.07)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).
OSOther associated drugs subgroup	exploratoryPignon 2008	—	—	HR 0.97 (95% CI 0.84–1.13)The effect of chemotherapy did not vary significantly with the associated drug (test for interaction P = .11).

Hazard ratio (95% CI) by endpoint. Values below 1 favour the experimental arm.

Data table

Endpoint	HR	95% CI
OS	0.89	0.82–0.96
OS	1.4	0.95–2.06
OS	0.93	0.78–1.1
OS	0.83	0.73–0.95
OS	0.83	0.72–0.94
OS	0.8	0.7–0.91
OS	0.92	0.8–1.07
OS	0.97	0.84–1.13

Appears in

2004 Adjuvant cisplatin after resection: IALT, JBR.10 and LACE

Sources

Pignon JP, Tribodet H, Scagliotti GV, Douillard JY, Shepherd FA, Stephens RJ, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol. 2008;26(21):3552-9.
PubMed DOI