A randomized phase III study of adjuvant chemotherapy with or without low-molecular weight heparin in completely resected non-small-cell lung cancer patients with high-risk for recurrence: NVALT 8B

1. Patients with NSCLC, pT2N0, pT1N1, pT2N1, pT3N0 and pT3N1

2. SUVmax >- 10

3. Patients with NSCLC who had a surgical R0 resection

4. Age > 18 years

5. WHO performance score <- 2 before chemotherapy

6. Adequate organ function before administration of chemotherapy, including:

Adequate bone marrow reserve: ANC >- 1.5 x 109/l, platelets >- 100 x 109/L

Hepatic: bilirubin<- 1.5 ULN, AP, ALT, AST <- 3.0 x ULN.

Renal: calculated creatinine clearance >- 60 ml/min based on the Cockroft and Gault formula.
INR< 1.5

7. Patients must sign and date a written independent Ethics Committee approved informed consent form

1. Patients with incomplete or inadequate pulmonary resections. incomplete preoperative or intraoperative staging, wedge or segmental resection.

2. Prior chemotherapy or radical radiotherapy.

3. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, severe cardiac arrhythmia requiring medication, hepatic, renal or metabolic disease).

4. Concomitant treatment with any other experimental drug under investigation.

5. Inability to interrupt aspirin or other nonsteroidal anti-inflammatory agents for a 5-day period (8 day period for long-acting agents such as piroxicam).

6. Inability or unwillingness to take folic acid, vitamin B-12 supplementation or dexamethasone.

7. History of any active malignancy (other than NSCLC) unless treated more than 3 years with curative intent and no recurrence, except non-melanoma skin cancer or in situ cervical cancer.

8. Pregnancy

9. Men and women of child-bearing potential not using effective means of contraception for 6 months after treatment has been completed

10. Indication for anticoagulant treatment.

11. Any contraindication listed in the labeling of nadroparin.

12. Documented history of heparin-induced thrombocytopenia with UFH or LMWH

13. Current active bleeding or judged to be as high risk of bleeding;