The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis

Hakan Bozcuk; Huseyin Abali; Senol Coskun; Adnan Aydiner; Ahmet Çinkaya; Ahmet Demirkazik; Ahmet Özet; Ahmet Yolcu; Arzu Balkan; Ayhan Çavdar; Aysegül Üçüncü Kefeli; Basak Oyan Uluç; Beste Atasoy; Binnaz Demirkan; Bülent Yalçin; Celalettin Eroglu; Deniz Yalman; Diclehan Kiliç; Didem Tunali; Dinçer Firat; E. Selçuk Seber; Emel Üçgül Çavusoglu; Engin Ulukaya; Esra Kaytan Saglam; Evrim Tezcanli; Ezgi Eryilmaz; Fazilet Öner Dinçbas; Ferhat Telli; Fulden Yumuk; Gül Basaran; Hale Basak Çaglar; Halil Sönmez; Hasan Yilmaz; Hüseyin Engin; Kaan Helvaci; Kemal Sönmez; Lokman Koral; Mehmet Artaç; Mehmet Fuat Eren; Muharrem Koçar; Murat Beyzadeoglu; Mustafa Akin; Mustafa Benekli; Mustafa Cengiz; Mustafa Erman; Mustafa Yildiz; Mutlu Dogan; Müjdat Balkan; Nil Eraktug; Olçun Ümit Ünal; Orhan Sencan; Ö Petek Erpolat; Pinar Saip; Sadettin Kiliçkap; Sait Okkan Selçuk Seber; Semra Paydas; Süreyya Sarihan; Seref Kömürcü; Taciser Demirkasimoglu; Taner Korkmaz; Tarkan Yetisyigit; Tugba Yavuzsen; Türkkan Evrensel; Tülay Akman; Ufuk Abacioglu; Umut Kefeli; Ünal Egeli; Yesim Elgin; Yusuf Baran; Zeynep Bulut

doi:10.1186/1477-7819-10-161

The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis

Hakan Bozcuk, Huseyin Abali, Senol Coskun, Adnan Aydiner, Ahmet Çinkaya, Ahmet Demirkazik, Ahmet Özet, Ahmet Yolcu, Arzu Balkan, Ayhan Çavdar, Aysegül Üçüncü Kefeli, Basak Oyan Uluç, Beste Atasoy, Binnaz Demirkan, Bülent Yalçin, Celalettin Eroglu, Deniz Yalman, Diclehan Kiliç, Didem Tunali, Dinçer FiratE. Selçuk Seber, Emel Üçgül Çavusoglu, Engin Ulukaya, Esra Kaytan Saglam, Evrim Tezcanli, Ezgi Eryilmaz, Fazilet Öner Dinçbas, Ferhat Telli, Fulden Yumuk, Gül Basaran, Hale Basak Çaglar, Halil Sönmez, Hasan Yilmaz, Hüseyin Engin, Kaan Helvaci, Kemal Sönmez, Lokman Koral, Mehmet Artaç, Mehmet Fuat Eren, Muharrem Koçar, Murat Beyzadeoglu, Mustafa Akin, Mustafa Benekli, Mustafa Cengiz, Mustafa Erman, Mustafa Yildiz, Mutlu Dogan, Müjdat Balkan, Nil Eraktug, Olçun Ümit Ünal, Orhan Sencan, Ö Petek Erpolat, Pinar Saip, Sadettin Kiliçkap, Sait Okkan Selçuk Seber, Semra Paydas, Süreyya Sarihan, Seref Kömürcü, Taciser Demirkasimoglu, Taner Korkmaz, Tarkan Yetisyigit, Tugba Yavuzsen, Türkkan Evrensel, Tülay Akman, Ufuk Abacioglu, Umut Kefeli, Ünal Egeli, Yesim Elgin, Yusuf Baran, Zeynep Bulut

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Background: Although neoadjuvant chemotherapy (NCT) is widely used, it is not clear which subgroup of locally advanced non-small-cell lung cancer (NSCLC) patients should be treated with this approach, and if a particular benefit associated with NCT exists. In this study, we aimed to investigate the potential correlates of benefit from NCT in patients with NSCLC.Methods: All randomized clinical trials (RCTs) utilizing a NCT arm (without radiotherapy) versus a control arm before surgery were included for metaregression analysis. All regression analyses were weighed for trial size. Separate analyses were conducted for trials recruiting patients with different stages of disease. Previously published measures of treatment efficacy were used for the purpose of this study, regardless of being published in full text or abstract form.Results: A total of 14 RCTs, consisting of 3,615 patients, were selected. Histology, stage, various characteristics of the NCT protocol, and different trial features including trial quality score were not associated with the benefit of NCT. However, in trials of stage 3 disease only, there was a greater benefit in terms of reduction in mortality from NCT, if protocols with three chemotherapeutics were used (B = -0.18, t = -5.25, P = 0.006).Conclusions: We think that patients with stage 3 NSCLC are served better with NCT before surgery if protocols with three chemotherapy agents or equally effective combinations are used. In addition, the effect of neoadjuvant chemotherapy is consistent with regard to disease and patient characteristics. This finding should be tested in future RCTs or individual patient data meta-analyses.

Original language	English (US)
Article number	161
Journal	World Journal of Surgical Oncology
Volume	10
DOIs	https://doi.org/10.1186/1477-7819-10-161
State	Published - Aug 9 2012
Externally published	Yes

Keywords

Meta-analysis
Metaregression
Mortality
Neoadjuvant chemotherapy
Non-small-cell lung cancer

ASJC Scopus subject areas

Surgery
Oncology

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10.1186/1477-7819-10-161

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Bozcuk, H., Abali, H., Coskun, S., Aydiner, A., Çinkaya, A., Demirkazik, A., Özet, A., Yolcu, A., Balkan, A., Çavdar, A., Kefeli, A. Ü., Uluç, B. O., Atasoy, B., Demirkan, B., Yalçin, B., Eroglu, C., Yalman, D., Kiliç, D., Tunali, D., ... Bulut, Z. (2012). The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis. World Journal of Surgical Oncology, 10, Article 161. https://doi.org/10.1186/1477-7819-10-161

Bozcuk, H, Abali, H, Coskun, S, Aydiner, A, Çinkaya, A, Demirkazik, A, Özet, A, Yolcu, A, Balkan, A, Çavdar, A, Kefeli, AÜ, Uluç, BO, Atasoy, B, Demirkan, B, Yalçin, B, Eroglu, C, Yalman, D, Kiliç, D, Tunali, D, Firat, D, Seber, ES, Çavusoglu, EÜ, Ulukaya, E, Saglam, EK, Tezcanli, E, Eryilmaz, E, Dinçbas, FÖ, Telli, F, Yumuk, F, Basaran, G, Çaglar, HB, Sönmez, H, Yilmaz, H, Engin, H, Helvaci, K, Sönmez, K, Koral, L, Artaç, M, Eren, MF, Koçar, M, Beyzadeoglu, M, Akin, M, Benekli, M, Cengiz, M, Erman, M, Yildiz, M, Dogan, M, Balkan, M, Eraktug, N, Ünal, OÜ, Sencan, O, Erpolat, ÖP, Saip, P, Kiliçkap, S, Seber, SOS, Paydas, S, Sarihan, S, Kömürcü, S, Demirkasimoglu, T, Korkmaz, T, Yetisyigit, T, Yavuzsen, T, Evrensel, T, Akman, T, Abacioglu, U, Kefeli, U, Egeli, Ü, Elgin, Y, Baran, Y & Bulut, Z 2012, 'The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis', World Journal of Surgical Oncology, vol. 10, 161. https://doi.org/10.1186/1477-7819-10-161

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abstract = "Background: Although neoadjuvant chemotherapy (NCT) is widely used, it is not clear which subgroup of locally advanced non-small-cell lung cancer (NSCLC) patients should be treated with this approach, and if a particular benefit associated with NCT exists. In this study, we aimed to investigate the potential correlates of benefit from NCT in patients with NSCLC.Methods: All randomized clinical trials (RCTs) utilizing a NCT arm (without radiotherapy) versus a control arm before surgery were included for metaregression analysis. All regression analyses were weighed for trial size. Separate analyses were conducted for trials recruiting patients with different stages of disease. Previously published measures of treatment efficacy were used for the purpose of this study, regardless of being published in full text or abstract form.Results: A total of 14 RCTs, consisting of 3,615 patients, were selected. Histology, stage, various characteristics of the NCT protocol, and different trial features including trial quality score were not associated with the benefit of NCT. However, in trials of stage 3 disease only, there was a greater benefit in terms of reduction in mortality from NCT, if protocols with three chemotherapeutics were used (B = -0.18, t = -5.25, P = 0.006).Conclusions: We think that patients with stage 3 NSCLC are served better with NCT before surgery if protocols with three chemotherapy agents or equally effective combinations are used. In addition, the effect of neoadjuvant chemotherapy is consistent with regard to disease and patient characteristics. This finding should be tested in future RCTs or individual patient data meta-analyses.",

keywords = "Meta-analysis, Metaregression, Mortality, Neoadjuvant chemotherapy, Non-small-cell lung cancer",

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year = "2012",

month = aug,

day = "9",

doi = "10.1186/1477-7819-10-161",

language = "English (US)",

volume = "10",

journal = "World Journal of Surgical Oncology",

issn = "1477-7819",

publisher = "BioMed Central",

}

TY - JOUR

T1 - The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer

T2 - a metaregression analysis

AU - Bozcuk, Hakan

AU - Abali, Huseyin

AU - Coskun, Senol

AU - Aydiner, Adnan

AU - Çinkaya, Ahmet

AU - Demirkazik, Ahmet

AU - Özet, Ahmet

AU - Yolcu, Ahmet

AU - Balkan, Arzu

AU - Çavdar, Ayhan

AU - Kefeli, Aysegül Üçüncü

AU - Uluç, Basak Oyan

AU - Atasoy, Beste

AU - Demirkan, Binnaz

AU - Yalçin, Bülent

AU - Eroglu, Celalettin

AU - Yalman, Deniz

AU - Kiliç, Diclehan

AU - Tunali, Didem

AU - Firat, Dinçer

AU - Seber, E. Selçuk

AU - Çavusoglu, Emel Üçgül

AU - Ulukaya, Engin

AU - Saglam, Esra Kaytan

AU - Tezcanli, Evrim

AU - Eryilmaz, Ezgi

AU - Dinçbas, Fazilet Öner

AU - Telli, Ferhat

AU - Yumuk, Fulden

AU - Basaran, Gül

AU - Çaglar, Hale Basak

AU - Sönmez, Halil

AU - Yilmaz, Hasan

AU - Engin, Hüseyin

AU - Helvaci, Kaan

AU - Sönmez, Kemal

AU - Koral, Lokman

AU - Artaç, Mehmet

AU - Eren, Mehmet Fuat

AU - Koçar, Muharrem

AU - Beyzadeoglu, Murat

AU - Akin, Mustafa

AU - Benekli, Mustafa

AU - Cengiz, Mustafa

AU - Erman, Mustafa

AU - Yildiz, Mustafa

AU - Dogan, Mutlu

AU - Balkan, Müjdat

AU - Eraktug, Nil

AU - Ünal, Olçun Ümit

AU - Sencan, Orhan

AU - Erpolat, Ö Petek

AU - Saip, Pinar

AU - Kiliçkap, Sadettin

AU - Seber, Sait Okkan Selçuk

AU - Paydas, Semra

AU - Sarihan, Süreyya

AU - Kömürcü, Seref

AU - Demirkasimoglu, Taciser

AU - Korkmaz, Taner

AU - Yetisyigit, Tarkan

AU - Yavuzsen, Tugba

AU - Evrensel, Türkkan

AU - Akman, Tülay

AU - Abacioglu, Ufuk

AU - Kefeli, Umut

AU - Egeli, Ünal

AU - Elgin, Yesim

AU - Baran, Yusuf

AU - Bulut, Zeynep

PY - 2012/8/9

Y1 - 2012/8/9

N2 - Background: Although neoadjuvant chemotherapy (NCT) is widely used, it is not clear which subgroup of locally advanced non-small-cell lung cancer (NSCLC) patients should be treated with this approach, and if a particular benefit associated with NCT exists. In this study, we aimed to investigate the potential correlates of benefit from NCT in patients with NSCLC.Methods: All randomized clinical trials (RCTs) utilizing a NCT arm (without radiotherapy) versus a control arm before surgery were included for metaregression analysis. All regression analyses were weighed for trial size. Separate analyses were conducted for trials recruiting patients with different stages of disease. Previously published measures of treatment efficacy were used for the purpose of this study, regardless of being published in full text or abstract form.Results: A total of 14 RCTs, consisting of 3,615 patients, were selected. Histology, stage, various characteristics of the NCT protocol, and different trial features including trial quality score were not associated with the benefit of NCT. However, in trials of stage 3 disease only, there was a greater benefit in terms of reduction in mortality from NCT, if protocols with three chemotherapeutics were used (B = -0.18, t = -5.25, P = 0.006).Conclusions: We think that patients with stage 3 NSCLC are served better with NCT before surgery if protocols with three chemotherapy agents or equally effective combinations are used. In addition, the effect of neoadjuvant chemotherapy is consistent with regard to disease and patient characteristics. This finding should be tested in future RCTs or individual patient data meta-analyses.

AB - Background: Although neoadjuvant chemotherapy (NCT) is widely used, it is not clear which subgroup of locally advanced non-small-cell lung cancer (NSCLC) patients should be treated with this approach, and if a particular benefit associated with NCT exists. In this study, we aimed to investigate the potential correlates of benefit from NCT in patients with NSCLC.Methods: All randomized clinical trials (RCTs) utilizing a NCT arm (without radiotherapy) versus a control arm before surgery were included for metaregression analysis. All regression analyses were weighed for trial size. Separate analyses were conducted for trials recruiting patients with different stages of disease. Previously published measures of treatment efficacy were used for the purpose of this study, regardless of being published in full text or abstract form.Results: A total of 14 RCTs, consisting of 3,615 patients, were selected. Histology, stage, various characteristics of the NCT protocol, and different trial features including trial quality score were not associated with the benefit of NCT. However, in trials of stage 3 disease only, there was a greater benefit in terms of reduction in mortality from NCT, if protocols with three chemotherapeutics were used (B = -0.18, t = -5.25, P = 0.006).Conclusions: We think that patients with stage 3 NSCLC are served better with NCT before surgery if protocols with three chemotherapy agents or equally effective combinations are used. In addition, the effect of neoadjuvant chemotherapy is consistent with regard to disease and patient characteristics. This finding should be tested in future RCTs or individual patient data meta-analyses.

KW - Meta-analysis

KW - Metaregression

KW - Mortality

KW - Neoadjuvant chemotherapy

KW - Non-small-cell lung cancer

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UR - http://www.scopus.com/inward/citedby.url?scp=84864723399&partnerID=8YFLogxK

U2 - 10.1186/1477-7819-10-161

DO - 10.1186/1477-7819-10-161

M3 - Article

C2 - 22877422

AN - SCOPUS:84864723399

SN - 1477-7819

VL - 10

JO - World Journal of Surgical Oncology

JF - World Journal of Surgical Oncology

M1 - 161

ER -

The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis

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Keywords

ASJC Scopus subject areas

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