JTCVS open · 2026
Induction chemotherapy plus bevacizumab or radiotherapy in N2 non-squamous non-small cell lung cancer: 5-year results of a randomized phase 2 trial.
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Takamochi Kazuya, Suzuki Kenji, Tsuboi Masahiro, Niho Seiji, Ishikura Satoshi, Kobayashi Shota, Oyamada Shunsuke, Yamaguchi Takuhiro, Suzuki Hidemi, Ito Hiroyuki, Okumura Norihito, Tanaka Fumihiro, Saji Hisashi, Koike Terumoto, Horio Hirotoshi, Endo Makoto, Fujiwara Toshiya, Ikeda Norihiko, Tanaka Toshiki, Iwata Hisashi, Haruki Tomohiro, Suzuki Hiroyuki, Maniwa Yoshimasa, Shiono Satoshi, Okada Morihito, Advanced Clinical Trial Chest Surgery Group (ACTG)
Аннотация
OBJECTIVES: The Personalized Induction Therapy-1 (PIT-1) trial is a multicenter, randomized, phase 2 selection design study in which patients with stage IIIA (N2) non-squamous non-small cell lung cancer received pemetrexed plus cisplatin with bevacizumab or concurrent thoracic radiotherapy, both followed by surgery. Herein, we report the 5-year survival outcomes.
METHODS: Eighty-two patients (42 in the bevacizumab arm and 40 in the radiotherapy arm) received induction therapy, and 75 patients (38 and 37, respectively) underwent surgery. Five-year overall survival and progression-free survival were compared between arms in the 82 eligible patients. In addition, overall survival, relapse-free survival, and patterns of postoperative relapse were analyzed in the 75 patients who underwent surgery.
RESULTS: Among the 82 treated patients, the 5-year overall survival rate was 63.5% (95% CI, 46.9-76.1) in the bevacizumab arm and 57.2% (95% CI, 40.5-70.8) in the radiotherapy arm (P = .57). The 5-year progression-free survival rate was 26.2% (95% CI, 14.1-40.0) and 27.5% (95% CI, 14.9-41.7), respectively (P = .36). Recurrence of ipsilateral hilar or mediastinal lymph nodes (within the irradiation field) was significantly lower in the radiotherapy arm (n = 1, 3%) than in the bevacizumab arm (n = 7, 18%, P = .01). All patients with relapse in the PIT-1 trial (except 1 patient in the radiotherapy arm) received at least 1 subsequent therapy.
CONCLUSIONS: Five-year survival outcomes did not differ between treatment arms. The radiotherapy arm exhibited sufficient local control within the irradiated field.
METHODS: Eighty-two patients (42 in the bevacizumab arm and 40 in the radiotherapy arm) received induction therapy, and 75 patients (38 and 37, respectively) underwent surgery. Five-year overall survival and progression-free survival were compared between arms in the 82 eligible patients. In addition, overall survival, relapse-free survival, and patterns of postoperative relapse were analyzed in the 75 patients who underwent surgery.
RESULTS: Among the 82 treated patients, the 5-year overall survival rate was 63.5% (95% CI, 46.9-76.1) in the bevacizumab arm and 57.2% (95% CI, 40.5-70.8) in the radiotherapy arm (P = .57). The 5-year progression-free survival rate was 26.2% (95% CI, 14.1-40.0) and 27.5% (95% CI, 14.9-41.7), respectively (P = .36). Recurrence of ipsilateral hilar or mediastinal lymph nodes (within the irradiation field) was significantly lower in the radiotherapy arm (n = 1, 3%) than in the bevacizumab arm (n = 7, 18%, P = .01). All patients with relapse in the PIT-1 trial (except 1 patient in the radiotherapy arm) received at least 1 subsequent therapy.
CONCLUSIONS: Five-year survival outcomes did not differ between treatment arms. The radiotherapy arm exhibited sufficient local control within the irradiated field.