Age and Comorbidity As Independent Prognostic Factors in the Treatment of Non–Small-Cell Lung Cancer: A Review of National Cancer Institute of Canada Clinical Trials Group Trials

Asmis, Timothy R.; Ding, Keyue; Seymour, Lesley; Shepherd, Frances A.; Leighl, Natasha B.; Winton, Tim; Whitehead, Marlo; Spaans, Johanna N.; Graham, Barbara; Goss, Glenwood D.

doi:10.1200/jco.2007.12.8322

Cited by 302 publications

(217 citation statements)

References 34 publications

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“…The reason for differences in comorbidity factors rates may be these previous studies include for the mostpart, patientswith early stage (Stage I-III) NSCLC. [16][17][18] The prevalance of diabetes in our study was higher than that was found in similar, previous studies in the literature. There are conflicting data about the relationship between diabetes and incidence of NSCLC in the literature so that it is not possible to make a precise conclusion about this subject at this time.…”

Section: Cumulative Survivalcontrasting

confidence: 58%

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

Akman¹

2014

UHOD

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The aim of the study was to investigate the impact of accompanying comorbidities on survival in non-small-cell lung carcinoma (NSCLC) patients. A total of 221 patients with stage IIIB-IV NSLC between May 1998 and April 2009 were included. Survival data was analyzed according to age (those younger than 65 and those 65 and older) and Charlson Comorbidity Index (CCI) scores. Eighty-six (39%) patients were aged 65 and older, and the remaining 135 (61%) were younger than 65. In the 65 and over group the median survival of patients was 44 months for CCI Group 0, 16 months for CCI Group 1, 10 months for CCI Group 2, and 10 months for CCI Group 3. For the younger group, the median survival time was 19 months for CCI Group 0, 18 months for CCI Group 1, 11 months for CCI Group 2, and 11 months for CCI Group 3. There were no statistically significant differences in the comorbidity factors regarding survival in the two groups of patients. In conclusion, the frequency of comorbidity factors increased in stage IIIB and IV NSCLC patients as age increased. Although survival in patients with higher CCI scores was shorter, the CCI was not associated with survival for patients having local advanced and metastatic disease; no significant difference was found statistically for these patients. Therefore, these patients need to be managed more thoroughly.

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Section: Cumulative Survivalcontrasting

confidence: 58%

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

Akman¹

2014

UHOD

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“…Smoking status was demonstrated in previous reports to be an important prognostic factor due to its influence on overall survival (OS) regardless of the treatment received [7] . Histology [8,9] , co-morbidity using the Charlson score [10] and admission performance status [11] also have an impact on OS and patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Epidermal growth factor receptor and K-Ras in non-small cell lung cancer-molecular pathways involved and targeted therapies

Mello

Marques²,

Medeiros³

et al. 2011

WJCO

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Lung cancer is currently the leading cause of cancer death in Western nations. Non-small cell lung cancer (NSCLC) represents 80% of all lung cancers, and adenocarcinoma is the predominant histological type. Despite the intensive research carried out on this field and therapeutic advances, the overall prognosis of these patients remains unsatisfactory, with a 5-year overall survival rate of less than 15%. Nowadays, pharmacogenetics and pharmacogenomics represent the key to successful treatment. Recent studies suggest the existence of two distinct molecular pathways in the carcinogenesis of lung adenocarcinoma: one associated with smoking and activation of the K-Ras oncogene and the other not associated with smoking and activation of the epidermal growth factor receptor (EGFR). The K-ras mutation is mainly responsible for primary resistance to new molecules which inhibit tyrosine kinase EGFR (erlotinib and gefitinib) and most of the EGFR mutations are responsible for increased tumor sensitivity to these drugs. This article aims to conduct a systematic review of the literature regarding the molecular pathways involving the EGFR, K-Ras and EGFR targeted therapies in NSCLC tumor behavior.

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“…In addition, a potential positive selection bias could be considered, because HDCT has been administered to patients with good performance status and without comorbidity. 16 These results suggest that as with other diseases, sensitivity to standard doses of treatment is an important prognostic factor that can be used for predicting benefit from intensive therapy. If this approach were to be explored in future trials, then subsequent treatment with HDC should be limited to those patients achieving a significant response to induction therapy.…”

Section: Discussionmentioning

confidence: 84%

High-dose chemotherapy with peripheral blood progenitor cell support for patients with non-small cell lung cancer: the experience of the European Group for Bone Marrow Transplantation (EBMT) Solid Tumours Working Party

Giorgi

Blaise

Lange³

et al. 2007

Bone Marrow Transplant

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We report the experience of the EBMT Solid Tumours Working Party (STWP) using high-dose chemotherapy (HDCT) with PBPC support in patients with non-small cell lung cancer (NSCLC). Between 1989 and 2004, 36 NSCLC patients (27 men and 9 women), median age 53.5 years (range: 24-62) were treated with 63 HDCT courses. A high-dose carboplatin-based regimen was used in 53% of the cases. Thirty-two patients had relapsed/metastatic disease, while four classified as stage IIIB received HDCT followed by radiotherapy. No treatment-related death occurred. Of 25 patients who were planned to receive multi-cycle HDCT, 4 cases (16%) interrupted the treatment early due to prolonged severe toxicities and 4 (16%) due to progressive disease. Of 36 evaluable patients, 3 (8%) achieved a complete remission and 13 (36%) had a partial remission at an overall response rate of 44%. Of these, one patient with stage IIIB and one with stage IV are alive disease free at 71 þ and 149 þ months, respectively. After a median follow-up of 48 months (range: 6-149), median survival was 7 months (range: 1-149). Despite one anecdotal case, HDCT did not show significant activity, but induced relevant morbidity in NSCLC patients.

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Age and Comorbidity As Independent Prognostic Factors in the Treatment of Non–Small-Cell Lung Cancer: A Review of National Cancer Institute of Canada Clinical Trials Group Trials

Abstract: In these large, randomized trials, the presence of comorbid conditions (CCIS > or = 1), rather than age more than 65 years, was associated with poorer survival.

Cited by 302 publications

References 34 publications

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

Epidermal growth factor receptor and K-Ras in non-small cell lung cancer-molecular pathways involved and targeted therapies

High-dose chemotherapy with peripheral blood progenitor cell support for patients with non-small cell lung cancer: the experience of the European Group for Bone Marrow Transplantation (EBMT) Solid Tumours Working Party

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