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 journalArticlepeer-review

9 Scopus citations


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 languageEnglish (US)
Article number161
JournalWorld Journal of Surgical Oncology
StatePublished - Aug 9 2012
Externally publishedYes


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

ASJC Scopus subject areas

  • Surgery
  • Oncology


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