The impact of PET imaging on outcomes in patients with stage III non-small cell lung cancer (NSCLC) treated with chemoradiation: A subset analysis of HOG LUN 01-24/USO-023.

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7065 Background: FDG-PET is part of the NCCN recommendations for the pretreatment evaluation of patients with early stage NSCLC. Others have reported improved survival in patients with stage III NSCLC staged by PET. It has been hypothesized that improved outcomes can be realized by PET imaging to reduce treating patients with unsuspected stage IV disease and may improve planning. We, therefore, evaluated the role of PET scan and outcomes treated on a phase III study of cisplatin (P), etoposide (E), and concurrent chest radiation (XRT) with our without consolidation docetaxel (CD). Methods: Eligible patients received standard treatment with EP and concurrent XRT. Those with nonprogression were subsequently randomized to receive CD versus observation (OO). Log-ranked tests were used to evaluate the association of pretreatment PET with overall survival. Comparisons were made of the entire patient set (n=243) with respect to PET versus no PET along with comparison of only randomized patients (n=166). Results: The PET versus no PET groups were well matched except that PET patients on average had a better performance status (62% vs. 52%) and lower stage IIIA (45% vs. 31%). Overall survival outcomes by PET are summarized in the Table. Conclusions: This retrospective, subset analysis of a phase III trial suggests that the use of PET at baseline did not result in substantially better outcomes for patients with stage III NSCLC treated with chemoradiation. Patient population PET MST NO PET MST HR p value All (n=243) 22.8 mo (n=169) 20.1 mo (n=74) 0.84 0.3352 Randomized (n=166) 24.7 mo (n=113) 25.4 mo (n=53) 0.77 0.2250 CD (n=82) 21.5 mo (n=51) 35.1 mo (n=31) 0.58 0.0624 OO (n=84) 28.4 mo (n=62) 17.6 mo (n=22) 1.13 0.6934 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration US Oncology, Inc. OSI Celgene, Genentech, Lilly, Pfizer

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