TY - JOUR
T1 - Smoking Behavior in Patients With Early-Stage NSCLC
T2 - A Report From ECOG-ACRIN 1505 Trial
AU - ECOG-ACRIN 1505 Investigators
AU - Steuer, Conor E.
AU - Jegede, Opeyemi A.
AU - Dahlberg, Suzanne E.
AU - Wakelee, Heather A.
AU - Keller, Steven M.
AU - Tester, William J.
AU - Gandara, David R.
AU - Graziano, Stephen L.
AU - Adjei, Alex A.
AU - Butts, Charles A.
AU - Ramalingam, Suresh S.
AU - Schiller, Joan H.
N1 - Publisher Copyright:
© 2021 International Association for the Study of Lung Cancer
PY - 2021/6
Y1 - 2021/6
N2 - Introduction: Smoking cessation has been reported to benefit patients even after a diagnosis of lung cancer. We studied the smoking behavior of patients who participated in a phase 3 trial of adjuvant therapy following resection of stages IB–IIIA NSCLC. Methods: The ECOG-ACRIN 1505 was conducted to determine whether the addition of bevacizumab to adjuvant chemotherapy would improve overall survival (OS) for patients with early-stage NSCLC. Studying the association between smoking status and OS was a secondary end point. Patients completed a questionnaire on their smoking habits at baseline, 3, 6, 9, and 12 months. Results: A total of 1501 patients were enrolled, and 99.8%, 95%, 94%, 93%, and 93% responded to the questionnaire at baseline, 3, 6, 9, and 12 months, respectively. A total of 90% reported a current or previous history of cigarette smoking. In addition, 60% of nonsmokers at enrollment reported smoking after diagnosis (before randomization); however, 1% of them reported smoking at 12 months. Furthermore, 94% of the respondents smoked none/fewer cigarettes daily at 12 months. The incidence of grades 3–5 toxicity on treatment was 68%, 76%, and 72% in never, former, and current smokers, respectively (p = 0.05). The disease-free survival for never-smokers relative to current and former smokers was (hazard ratio [HR] 0.93, p = 0.64 and HR 1.05, p = 0.72), and OS was (adjusted HR for death 0.54, p = 0.005 and adjusted HR for death 0.68, p = 0.03), respectively. Conclusions: This is the first comprehensive, prospective report of smoking habits in patients with NSCLC patients from a phase III early-stage trial. There was a high rate of smoking reduction and cessation following study entry. The disease-free survival did not differ significantly between smokers and never smokers, though there were less grade 3–5 toxicities and more favorable OS in never-smokers.
AB - Introduction: Smoking cessation has been reported to benefit patients even after a diagnosis of lung cancer. We studied the smoking behavior of patients who participated in a phase 3 trial of adjuvant therapy following resection of stages IB–IIIA NSCLC. Methods: The ECOG-ACRIN 1505 was conducted to determine whether the addition of bevacizumab to adjuvant chemotherapy would improve overall survival (OS) for patients with early-stage NSCLC. Studying the association between smoking status and OS was a secondary end point. Patients completed a questionnaire on their smoking habits at baseline, 3, 6, 9, and 12 months. Results: A total of 1501 patients were enrolled, and 99.8%, 95%, 94%, 93%, and 93% responded to the questionnaire at baseline, 3, 6, 9, and 12 months, respectively. A total of 90% reported a current or previous history of cigarette smoking. In addition, 60% of nonsmokers at enrollment reported smoking after diagnosis (before randomization); however, 1% of them reported smoking at 12 months. Furthermore, 94% of the respondents smoked none/fewer cigarettes daily at 12 months. The incidence of grades 3–5 toxicity on treatment was 68%, 76%, and 72% in never, former, and current smokers, respectively (p = 0.05). The disease-free survival for never-smokers relative to current and former smokers was (hazard ratio [HR] 0.93, p = 0.64 and HR 1.05, p = 0.72), and OS was (adjusted HR for death 0.54, p = 0.005 and adjusted HR for death 0.68, p = 0.03), respectively. Conclusions: This is the first comprehensive, prospective report of smoking habits in patients with NSCLC patients from a phase III early-stage trial. There was a high rate of smoking reduction and cessation following study entry. The disease-free survival did not differ significantly between smokers and never smokers, though there were less grade 3–5 toxicities and more favorable OS in never-smokers.
KW - Chemotherapy
KW - Clinical trial
KW - Lung cancer
KW - Outcomes
KW - Smoking
KW - Tobacco cessation
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U2 - 10.1016/j.jtho.2020.12.017
DO - 10.1016/j.jtho.2020.12.017
M3 - Article
C2 - 33539971
AN - SCOPUS:85100956046
SN - 1556-0864
VL - 16
SP - 960
EP - 967
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 6
ER -