BACKGROUND: Five-year survival in early-stage, non-squamous, non-small-cell lung cancer (NSCLC) remains poor compared with other solid tumors, even after complete resection. Post-operative management depends on prognostic staging to identify individuals at highest risk for death, and therefore with the greatest need for further intervention. A 14-gene quantitative RT-PCR test successfully differentiates stage I-III NSCLC patients who are at high-, intermediate-, or low-risk for 5-year mortality. This study assesses the impact of the assay's prognostic information on physician decisions regarding adjuvant chemotherapy. METHODS: We invited 115 physicians who ordered the test to participate in an on-line survey. The primary outcome measure was the proportion of patients with different pre- and post-test chemotherapy recommendations. RESULTS: Fifty-eight physicians (50 %) completed the survey on 120 stage I or II NSCLC patients. Ninety-one patients (76 %) had stage I lung cancer; 27 (23 %), 39 (33 %), and 54 (45 %) patients had low-, intermediate-, and high-risk scores, respectively. Physicians' chemotherapy recommendations were changed post-testing in 37 patients (30.8 %, 95 % CI 22.7-39.9 %). High-risk patients were more likely to have a change in treatment recommendation (44.4 %, 95 % CI 30.9-58.6 %) than low risk patients (3.7 %, 95 % CI 0.1-19.0 %); a substantial number of changes were observed in both stage I (33.0 %, 95 % CI 23.5-43.6 %) and stage II (24.1 %, 95 % CI 10.3-43.5 %). CONCLUSIONS: Our data show that the assay resulted in a significant impact on physician treatment decisions in early-stage NSCLC, and that the nature of treatment changes generally correlated with the test's assessment of risk.
BACKGROUND: Five-year survival in early-stage, non-squamous, non-small-cell lung cancer (NSCLC) remains poor compared with other solid tumors, even after complete resection. Post-operative management depends on prognostic staging to identify individuals at highest risk for death, and therefore with the greatest need for further intervention. A 14-gene quantitative RT-PCR test successfully differentiates stage I-III NSCLCpatients who are at high-, intermediate-, or low-risk for 5-year mortality. This study assesses the impact of the assay's prognostic information on physician decisions regarding adjuvant chemotherapy. METHODS: We invited 115 physicians who ordered the test to participate in an on-line survey. The primary outcome measure was the proportion of patients with different pre- and post-test chemotherapy recommendations. RESULTS: Fifty-eight physicians (50 %) completed the survey on 120 stage I or II NSCLCpatients. Ninety-one patients (76 %) had stage I lung cancer; 27 (23 %), 39 (33 %), and 54 (45 %) patients had low-, intermediate-, and high-risk scores, respectively. Physicians' chemotherapy recommendations were changed post-testing in 37 patients (30.8 %, 95 % CI 22.7-39.9 %). High-risk patients were more likely to have a change in treatment recommendation (44.4 %, 95 % CI 30.9-58.6 %) than low risk patients (3.7 %, 95 % CI 0.1-19.0 %); a substantial number of changes were observed in both stage I (33.0 %, 95 % CI 23.5-43.6 %) and stage II (24.1 %, 95 % CI 10.3-43.5 %). CONCLUSIONS: Our data show that the assay resulted in a significant impact on physician treatment decisions in early-stage NSCLC, and that the nature of treatment changes generally correlated with the test's assessment of risk.
Authors: Jean-Yves Douillard; Rafael Rosell; Mario De Lena; Francesco Carpagnano; Rodryg Ramlau; Jose Luis Gonzáles-Larriba; Tomasz Grodzki; Jose Rodrigues Pereira; Alain Le Groumellec; Vito Lorusso; Claude Clary; Antonio J Torres; Jabrail Dahabreh; Pierre-Jean Souquet; Julio Astudillo; Pierre Fournel; Angel Artal-Cortes; Jacek Jassem; Leona Koubkova; Patricia His; Marcello Riggi; Patrick Hurteloup Journal: Lancet Oncol Date: 2006-09 Impact factor: 41.316
Authors: Johannes R Kratz; Jianxing He; Stephen K Van Den Eeden; Zhi-Hua Zhu; Wen Gao; Patrick T Pham; Michael S Mulvihill; Fatemeh Ziaei; Huanrong Zhang; Bo Su; Xiuyi Zhi; Charles P Quesenberry; Laurel A Habel; Qiuhua Deng; Zongfei Wang; Jiangfen Zhou; Huiling Li; Mei-Chun Huang; Che-Chung Yeh; Mark R Segal; M Roshni Ray; Kirk D Jones; Dan J Raz; Zhidong Xu; Thierry M Jahan; David Berryman; Biao He; Michael J Mann; David M Jablons Journal: Lancet Date: 2012-01-27 Impact factor: 79.321
Authors: Charles A Butts; Keyue Ding; Lesley Seymour; Philip Twumasi-Ankrah; Barbara Graham; David Gandara; David H Johnson; Kenneth A Kesler; Mark Green; Mark Vincent; Yvon Cormier; Glenwood Goss; Brian Findlay; Michael Johnston; Ming-Sound Tsao; Frances A Shepherd Journal: J Clin Oncol Date: 2009-11-23 Impact factor: 44.544
Authors: S G Spiro; R M Rudd; R L Souhami; J Brown; D J Fairlamb; N H Gower; L Maslove; R Milroy; V Napp; M K B Parmar; M D Peake; R J Stephens; H Thorpe; D A Waller; P West Journal: Thorax Date: 2004-10 Impact factor: 9.139