The Triplet Vinorelbine (Nvb), Ifosfamide (Ifo) And Cisplatin (Cdop) (Nip) Used As Post-Operative Treatment Versus Surgery Alone In Patients Having Received Primary Chemotherapy (Ct) For Locally Advanced (La) Non Small Cell Lung Cancer (Nsclc).

7172 Background: Neo-adjuvant chemotherapy can allow resection in patients with locally advanced NSCLC. From January 1999 to December 2002, 156 patients have been enrolled in a prospective study aimed to evaluate downstaging after induction CT by NIP. Methods: Patients with IIIA; IIB (only T3N0) and IIIB (only T4N0) were eligible to enter into the study. All patients with clinical N2 had a mediastinoscopy plus biopsy or Fine Needle Aspiration (FNA) to certify the lymph node involvement. After receiving 3 cycles of NIP (NVB 25 mg/m2 d1, 5; IFO 3 g/m2 d1; MESNA 3g/m2 d1 and CDDP 80mg/m2 d1 every 3 weeks) all patients without progression or who were not withdrawn for any reason were eligible for surgery. No RT was allowed in both arms. Results: One hundred and seven patients (69%) were operated out of 155 patients treated by neoadjuvant chemotherapy. Lobectomy was possible in 54 patients (50%) and pneumonectomy was performed in 42 patients (39%). Atypical segmentectomy was performed in 1 patient (1%), explorative surgery in 6 patients (6%). Data are missing for 4 patients (4%). Complete resection rate (R0) was of 74% (79/107patients). Post-surgical downstaging was observed in 28% of the N2 patients who were completely resected. The median time to surgery was 32 days (range 21–67 days) from the last NVB administration. Peri-operative toxicity included intestinal obstruction, bronchial infection and empyema (1 patient each) and 3 patients died within 30 days after surgery (2 patients with left pneumonectomy and one with right pneumonectomy). With a median follow-up of 33 months, 16 patients (15%) with local relapse and 4 patients (4%) with supraclavicular lymph node relapse have been reported. Conclusion: The triplet combination of NIP allowed surgery in LA NSCLC without increasing either morbidity or mortality on this population. Moreover, no delay was reported between end of CT and surgery. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Pierre Fabre