ATRA FOR NSCLC

NEW YORK (Reuters Health) Jul 01 - Adding all-trans retinoic acid (ATRA) to cisplatin and paclitaxel improves outcome in patients with advanced non-small-cell lung cancer, Mexican researchers report in a June 14th online paper in the Journal of Clinical Oncology.

Dr. Oscar Arrieta of Instituto Nacional de Cancerologia, Mexico City, and colleagues note that lung cancer chemotherapy efficacy is limited in such patients, with responses ranging from 20% to 35%, and a 1-year survival rate of 35%.

To examine whether ATRA might help, the team conducted a phase II trial involving 107 patients with NSCLC stage IIIB with pleural effusion and stage IV disease.

All received paclitaxel and cisplatin every 21 days for a maximum of six cycles. They were randomly assigned to also receive ATRA or placebo daily 1 week before treatment and during two cycles of chemotherapy.

Median follow-up was for 12.2 months and median progression-free survival was 8.8 months in the ATRA group, significantly longer than the 6 months in the placebo group (p=0.008). The response rate was also significantly higher (55.8% versus 25.4%).

There were no significant between-group differences in grade 3 and 4 toxicity. However, 4 of the ATRA group had hypertriglyceridemia compared to none in the placebo group.

The researchers conclude that the approach appears safe and potentially useful and a phase III trial of chemotherapy with and without ATRA is currently in process.

http://jco.ascopubs.org/cgi/content/abstract/JCO.2009.26.6452v1

J Clin Oncol 2010.