Meta-analysis comparing doublet and single cytotoxic agent therapy as first-line treatment in elderly patients with advanced nonsmall-cell lung cancer

Wang, Shengfei; Wang, Qin; Tian, Jie; Zhou, Zhiyi; Jiao, Lijing; Yan-li, FU; Chen, Sufeng; Zhang, Jie; Xu, Ling

doi:10.1177/0300060514566649

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…Specifically, vinorelbine, a semi-synthetic vinca alkaloid, exhibits anti-cancer properties, especially against advanced NSCLC [ 14–16 ]. Carboplatin, part of the platinum-based anti-cancer drug family, is considered standard care for advanced NSCLC when used in combination therapies [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

MicroRNAs expression profile in chemotherapy-induced cardiotoxicity in NSCLC using a co-culture model

Romitan,

Zanoaga,

Budisan

et al. 2023

Biomol Biomed

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Clinical application of chemotherapy in lung cancer is constrained by side effects, notably cardiotoxicity, the mechanisms of which remain elusive. This study assessed the potential of specific miRNAs as biomarkers for chemotherapy-induced cardiotoxicity in lung cancer. We employed two lung adenocarcinoma cell lines (Calu6 and H1792) and ventricular normal human cardiac fibroblasts (NHCF-V) in single and co-culture experiments. Functional tests were conducted using 100 µM carboplatin and 1µM vinorelbine doses. The effects of carboplatin and vinorelbine, both individually and in combination, were evaluated at cellular and molecular levels 48h post-therapy for both mono- and co-cultures. miR-205-5p, miR-21-5p, and miR-30a-5p, modulated by anticancer treatments and influencing cardiotoxicity, were analyzed. Vinorelbine and carboplatin treatment promoted apoptosis and autophagy in lung cancer cells and cardiac fibroblasts more than in controls. Western blot analyses revealed BCL2 and p53 protein upregulation. Using qRT-PCR, we investigated the expression dynamics of miR-21-5p, miR-30c-5p, and miR-205-5p in co-cultured cardiomyocytes and lung cancer cells, revealing altered miRNA patterns from vinorelbine and carboplatin treatment. Our findings underscore the intricate relationship between chemotherapy, miRNA regulation, and cardiotoxicity, highlighting the importance of cardiac health in lung cancer treatment decisions.

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Section: Introductionmentioning

confidence: 99%

MicroRNAs expression profile in chemotherapy-induced cardiotoxicity in NSCLC using a co-culture model

Romitan,

Zanoaga,

Budisan

et al. 2023

Biomol Biomed

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“…Interestingly, in this same meta-analysis, these investigators reported that non-platinum-based doublet therapy offered no survival advantage over single agent therapy (HR = 0.93; 95% CI = (0.86, 1.01); p =0.078), thus further showing the importance of platinum-based chemotherapy in older non-small cell lung cancer patients. [2] This trade-off of modest survival in exchange for increased toxicity suggests a need to further study platinum-based doublet chemotherapy in the first-line setting in older non-small cell lung cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Do older patients with non-small cell lung cancer also benefit from first-line platinum-based doublet chemotherapy? Observations from a pooled analysis of 730 prospectively-treated patients (Alliance Study A151622)

Feliciano

Le‐Rademacher

Gajra

et al. 2018

Journal of Geriatric Oncology

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Objective: This study sought to define the role of first-line platinum-based doublet chemotherapy in older non-small cell lung cancer (NSCLC) patients. Methods: We analyzed three first-line NSCLC trials: CALGB 9730, CALGB 30203, and CALGB 30801, which tested carboplatin and paclitaxel; carboplatin and gemcitabine; and carboplatin with either pemetrexed or gemcitabine, respectively. Overall survival was the primary endpoint. Age-based comparisons with a cutpoint of 65 years were performed with Cox proportional hazards models with adjustments for sex, tumor histology, cancer stage, chemotherapy, and smoking history and after stratifying by performance score. Secondary endpoints were grade 3–5 adverse events, chemotherapy cycles completed, and whether toxicity prompted chemotherapy discontinuation. Results: 730 patients were included; 337 (46%) were 65+ years of age. No statistically significant difference in survival was observed for older (≥65) versus younger patients (HR = 1.096; 95% CI = (0.94, 1.28); p=0.25). A trend emerged with increased odds of a grade 3–5 adverse event for patients ≥65 years versus <65 years (OR =1.52; 95% CI = (0.99, 2.31); p = 0.05). The proportion of completed chemotherapy cycles was marginally lower in older patients (difference = −5%; 95% CI = (−9, 0.2); p=0.06) for those ≥65 years versus <65 years, but no statistically significant difference occurred in the rate of chemotherapy discontinuation for toxicity (OR = 1.4; 95% CI = (0.85, 2.19); p=0.21) for patients ≥65 years versus <65 years. A cutpoint of 70 years yielded similar results. Conclusion: These findings support carboplatin doublet-based chemotherapy in select older patients with advanced NSCLC.

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Efficacy and safety of carboplatin with nab-paclitaxel versus docetaxel in older patients with squamous non-small-cell lung cancer (CAPITAL): a randomised, multicentre, open-label, phase 3 trial

Kogure¹,

Iwasawa²,

Sasaki³

et al. 2021

The Lancet Healthy Longevity

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Meta-analysis comparing doublet and single cytotoxic agent therapy as first-line treatment in elderly patients with advanced nonsmall-cell lung cancer

Cited by 5 publications

References 27 publications

MicroRNAs expression profile in chemotherapy-induced cardiotoxicity in NSCLC using a co-culture model

MicroRNAs expression profile in chemotherapy-induced cardiotoxicity in NSCLC using a co-culture model

Do older patients with non-small cell lung cancer also benefit from first-line platinum-based doublet chemotherapy? Observations from a pooled analysis of 730 prospectively-treated patients (Alliance Study A151622)

Efficacy and safety of carboplatin with nab-paclitaxel versus docetaxel in older patients with squamous non-small-cell lung cancer (CAPITAL): a randomised, multicentre, open-label, phase 3 trial

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