Cisplatin-based chemotherapy in elderly patients with advanced stage (IIIB and IV) non-small cell lung cancer patients

Abstract

Lung cancer continues to be the leading cause of cancer-related mortality and approximately 70% of patients present with locally advanced or metastatic disease at the time of diagnosis. More than 50% of lung cancer cases are diagnosed in patients over the age of 65 years. The doublet chemotherapies consisting of platinum plus one of the third-generation agents become currently the standard regimen, the first line chemotherapy The most of the available data regarding the optimal treatment of lung cancer comes from clinical trials in which the vast majority of patients are significantly younger than 65 years of age.We aimed to investigate whether there is any difference in tolerability and efficacy in between adult(<65 years old) and elderly(≥65 years old) patients who received cisplatin based chemoteherapy or chemoradiotherapy for stage IIIB and IV non-small cell lun cancer.We The response rates were 30.3% in adults and 28.8% in elderly patients. The median survival was 13.6±1.4 months and 11.8±2.0 months for adults and elderly patients, respectively. The one-year, two year and five year survival rates were 37%, 9% , 4% for adult patients and 29%, 7%, 4% for elderly patients, respectively. There was no statistical difference between the groups. Percentages of grade 3-4 anemia (0% vs 6.6%) and grade 3-4 neutropenia (0% vs 4.4%) were higher in elderly patients than adult patients. Other toxic effects were similar among both of groups.In conclussion; standart cisplatin containing chemotherapy regimens (cisplatin plus gemcitabine or vinorelbine) can be used in elderly patients with advanced non-small cell lung cancer.

Butoxy Mansonone G Inhibits STAT3 and Akt Signaling Pathways in Non-Small Cell Lung Cancers: Combined Experimental and Theoretical Investigations

“…Cisplatin (CDDP), a platinum-based chemotherapeutic drug, has been commonly used to treat a wide range of solid malignancies, including lung cancer [10,11]. CDDP is the standard regimen in the first-line chemotherapy for patients with advanced stage NSCLC [10,12,13,14], especially patients carrying wild-type EGFR [15,16]. After cellular uptake, CDDP becomes a positively charged aquo complex that can interact with deoxyribonucleic acid (DNA) to form intra- and inter-strand cross-links, resulting in apoptosis induction [10,17].…”

Triptolide inhibits the multidrug resistance in prostate cancer cells via the downregulation of MDR1 expression

“…Chemotherapy has been widely used for the treatment of cancer and encouraging results have been achieved in some circumstances [13][14][15]. However, MDR has become one of the major problems for the effective treatment of tumors with chemotherapeutic agents, which is mainly resulted from the expression of transporters that remove the chemotherapeutic agents from the cytoplasm.…”

Pharmacogenetics of platinum-based chemotherapy: impact of DNA repair and folate metabolism gene polymorphisms on prognosis of non-small cell lung cancer patients

“…Chemotherapy versus best supportive care has showed improvement in terms of survival (10.7 months vs 3.9 months, respectively; p<0.001) and symptom control compared with best supportive care 6,7 . Nevertheless, the overall response rate (ORR) to platinum-based regimen is about 13-47.2% and only 16% of the patients are alive five years after diagnosis [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] . The knowledge of predictive and/or prognostic factors may improve clinical outcomes of NSCLC therapy, by stratifying patients into subgroups that could be managed differently.…”