Patients with lung cancer reduce smoking rate after enrollment in phase III clinical trial
The first comprehensive, prospective study of smoking habits in patients with non-small cell lung cancer (NSCLC) who were enrolled in a phase III early-stage trial revealed that there was a high rate of smoking reduction and cessation following study entry, according to research published today in the Journal of Thoracic Oncology.
Continued smoking after a lung cancer diagnosis is associated with an approximate 50% median increase in mortality, according to the 2014 Report of the Surgeon General.
Dr. Conor Steuer, Winship Cancer Institute of Emory University in Atlanta, and colleagues performed prospective assessments evaluating the patterns of tobacco use and cessation and the effects on outcomes. The study was done as part of the ECOG-ACRIN 1505 trial, which sought to determine whether the addition of bevacizumab to adjuvant chemotherapy would improve overall survival (OS) for patients with early stage resected NSCLC. The initial trial protocol studied tobacco usage patterns and the effects on overall outcomes as secondary endpoints.
The study surveyed 1,501 patients at baseline, three, six, nine and twelve months with NSCLC who were enrolled in the EA 1505 trial. Of those surveyed, 90% reported a current or previous history of cigarette smoking, but by the time of study enrollment only 11% reported being current smokers. For patients that reported smoking at time of their lung cancer diagnosis but no longer by the time of study, enrolment, 1% of them reported smoking at 12 months. Overall, 94% of respondents smoked no/fewer cigarettes daily at 12 months.
Steuer reported that DFS for never-smokers relative to current and former smokers was not significantly different (HR 0.93, p=0.64, HR 1.05, p=0.72), but overall survival was improved for never-smokers (adjusted HR for death 0.54, p=0.005, adjusted HR for death 0.68, p=0.03), respectively.
"This is the first comprehensive, prospective report of smoking habits in NSCLC patients from a phase III early-stage trial. There was a high rate of smoking reduction and cessation following study entry. DFS did not differ significantly between smokers and never smokers, though there were less grade 3-5 toxicities and more favorable OS in never-smokers," Steuer concluded.