A recent comprehensive, prospective study of smoking habits among patients with non-small cell lung cancer (NSCLC) demonstrated a high rate of smoking reduction and cessation following entry into the phase 3 early-stage trial.

According to the 2014 Report of the Surgeon General, continuing smoking following diagnosis with lung cancer is associated with an approximately 50% median increase in mortality.

To further investigate this finding, researchers conducted prospective assessments in the new study in order to evaluate the patterns of tobacco use and cessation alongside the effects of tobacco use on outcomes for patients with lung cancer.

In the initial trial protocol in the ECOG-ACRIN 1505 trial, researchers assessed whether the addition of bevacizumab to adjuvant chemotherapy would improve overall survival (OS) for patients with early stage resected NSCLC. As a secondary endpoint, they also investigated the effects of tobacco use on overall outcomes.

The researchers conducted surveys with 1501 patients with NSCLC at baseline, then at 3, 6, 9, and 12 months who had been enrolled in the EA 1505 trial. Among the patients surveyed, a current or previous history of cigarette smoking was reported in 90%, but only 11% reported being current smokers. One percent of patients reported that they were still smoking at the time of their lung cancer diagnosis but had stopped by the start of the study. In total, 94% of patients reported smoking fewer or no cigarettes daily at 12 months from baseline.

Study researcher Conor Steuer, MD, a medical oncologist a Winship Cancer Institute of Emory University, reported that among those who had never smoked, disease-free survival (DFS) was not significantly different from those who currently or formerly smoked (HR 0.93, p=0.64, HR 1.05, p=0.72), but OS was improved for those who had never smoked in relation to current or former smokers (adjusted HR for death 0.54, p=0.005, adjusted HR for death 0.68, p=0.03).

"This is the first comprehensive, prospective report of smoking habits in NSCLC patients from a phase 3 early-stage trial,” Steuer said in a press release. “There was a high rate of smoking reduction and cessation following study entry. DFS did not differ significantly between smokers and never smokers, though there were less grade 3 to 5 toxicities and more favorable OS in never-smokers."

Patients with lung cancer reduce smoking rate after enrollment in phase III clinical trial. Denver, CO: February 1, 2021. https://www.eurekalert.org/pub_releases/2021-02/iaft-pwl013021.php. Accessed February 16, 2021.