Dose intensity correlate with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer

Luciani, Andrea; Bertuzzi, C.; Ascione, G.; Gennaro, Elena Di; Bozzoni, S.; Zonato, S.; Ferrari, Daris; Foa, Paolo

doi:10.1016/j.lungcan.2008.12.019

Cited by 36 publications

(27 citation statements)

References 22 publications

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“…Many of us believe that administration of larger dose of chemotherapeutic agents over a defined period is more likely to result in success -the patient will have more chances to go into complete or partial remission, and this will improve survival (Luciani et al, 2009). However, several studies in the last decade have reported that larger doses of chemotherapy do not always improve prognosis (Stadtmauer et al, 2000;Möbus et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy-induced neutropenia as a prognostic factor in advanced non-small-cell lung cancer: results from Japan Multinational Trial Organization LC00-03

et al. 2009

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BACKGROUND: Neutropenia is a common adverse reaction of chemotherapy. We assessed whether chemotherapy-induced neutropenia could be a predictor of survival for patients with non-small-cell lung cancer (NSCLC). METHODS: A total of 387 chemotherapy-naïve patients who received chemotherapy (vinorelbine and gemcitabine followed by docetaxel, or paclitaxel and carboplatin) in a randomised controlled trial were evaluated. The proportional-hazards regression model was used to examine the effects of chemotherapy-induced neutropenia and tumour response on overall survival. Landmark analysis was used to lessen the bias of more severe neutropenia resulting from more treatment cycles allowed by longer survival, whereby patients who died within 126 days of starting chemotherapy were excluded. RESULTS: The adjusted hazard ratios for patients with grade-1 to 2 neutropenia or grade-3 to 4 neutropenia compared with no neutropenia were 0.59 (95% confidence interval (CI), 0.36 -0.97) and 0.71 (95% CI, 0.49 -1.03), respectively. The hazard ratios did not differ significantly between the patients who developed neutropenia with stable disease (SD), and those who lacked neutropenia with partial response (PR). CONCLUSION: Chemotherapy-induced neutropenia is a predictor of better survival for patients with advanced NSCLC. Prospective randomised trials of early-dose increases guided by chemotherapy-induced toxicities are warranted.

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Section: Discussionmentioning

confidence: 99%

Chemotherapy-induced neutropenia as a prognostic factor in advanced non-small-cell lung cancer: results from Japan Multinational Trial Organization LC00-03

et al. 2009

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“…Six studies reported RDI and overall survival in metastatic lung cancer: five in non-small cell lung cancer (NSCLC) and one in small cell lung cancer [13][14][15][16][17][18]. Of these six studies, two analyzed overall survival by RDI (Table 2) [13,18].…”

Section: Lung Cancermentioning

confidence: 99%

“…Of these six studies, two analyzed overall survival by RDI (Table 2) [13,18]. In a retrospective NSCLC study, Brunetto et al evaluated overall survival in 169 patients who received platinum-doublet chemotherapy using a prespecified RDI threshold of 90% and found that RDI across regimens was not associated with overall survival (platinum, P = 0.4; vinorelbine, P = 0.3; gemcitabine, P = 0.6) [13].…”

Section: Lung Cancermentioning

confidence: 99%

A review of relative dose intensity and survival in patients with metastatic solid tumors

Havrilesky

Reiner

Morrow

et al. 2015

Critical Reviews in Oncology/Hematology

114

101

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“…Treatment-related aes can affect patient quality of life and can lead to dose reductions and delays, which can affect treatment outcomes. In elderly patients with advanced nsclc, greater chemotherapy dose intensity was demonstrated to correlate with better survival outcomes 80 .…”

Section: Taxanes In the Elderlymentioning

confidence: 99%

Update on Taxanes in the First-Line Treatment of Advanced Non-Small-Cell Lung Cancer

Socinski¹

2014

Current Oncology

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standard-of-care options, and no single standardof-care regimen is superior in the treatment of advanced nsclc 7-10 . Thus, physicians rely on numerous factors to optimize treatment strategies, including histology, age, performance status, cost, tolerability, and convenience. The combination of a platinum agent with a taxane-either solvent-based (sb) paclitaxel (Taxol: Bristol-Myers Squibb, Princeton, NJ, U.S.A.) or docetaxel (Taxotere: SanofiAventis, Bridgewater, NJ, U.S.A.)-has a proven efficacy and safety profile in advanced nsclc 6 . The sb-paclitaxel-carboplatin regimen is among those most commonly used for the first-line treatment of advanced nsclc in the United States 11 .Recently, nab-paclitaxel, a 130-nm albuminbound ("nab") form of paclitaxel designed to use endogenous albumin pathways to increase intratumoural concentrations of the active drug, demonstrated improved antitumour activity and tolerability compared with sb-paclitaxel when both were used in combination with carboplatin in the first-line treatment of patients with advanced nsclc 12 . Based on the results of a phase iii trial, nab-paclitaxel in combination with carboplatin was approved in 2012 as first-line therapy for the treatment of locally advanced or metastatic nsclc in patients who are not candidates for curative surgery or radiation therapy 12,13 . The present review summarizes the clinical experience to date with taxanes in the first-line treatment of nsclc. DISCUSSION Taxane-Platinum CombinationsIn landmark nsclc studies, overall response rates (orrs) were higher with taxane-platinum combinations than with other chemotherapy regimens ( Table i). Historically, sb-paclitaxel given in combination with carboplatin or cisplatin demonstrated a median overall survival (os) of 7.7-10 months and an orr of 17%-41% [7][8][9]11,14,[16][17][18]22 . ABSTRACTBased on demonstrated favourable risk-benefit profiles, taxanes remain a key component in the first-line standard of care for advanced non-smallcell lung cancer (nsclc) and nsclc subtypes. In 2012, a novel taxane, nab-paclitaxel (Abraxane: Celgene Corporation, Summit, NJ, U.S.A.), was approved, in combination with carboplatin, for the first-line treatment of locally advanced or metastatic nsclc. The approval was granted because of demonstrated improved antitumour activity and tolerability compared with solvent-based paclitaxelcarboplatin in a phase iii trial. This review focuses on the evolution of first-line taxane therapy for advanced nsclc and the new options and advances in taxane therapy that might address unmet needs in advanced nsclc.

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Dose intensity correlate with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer

Cited by 36 publications

References 22 publications

Chemotherapy-induced neutropenia as a prognostic factor in advanced non-small-cell lung cancer: results from Japan Multinational Trial Organization LC00-03

Chemotherapy-induced neutropenia as a prognostic factor in advanced non-small-cell lung cancer: results from Japan Multinational Trial Organization LC00-03

A review of relative dose intensity and survival in patients with metastatic solid tumors

Update on Taxanes in the First-Line Treatment of Advanced Non-Small-Cell Lung Cancer

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