O-49 Age-specific subanalysis of ECOG 1594: Fit elderly patietns (70–80 yrs) with NSCLC do as well as younger patients (&lt;70)

Langer, Corey J.; Vangel, Mark; Schiller, Joan H.; Harrington, David R.; Sandier, Alan N.; Belani, Chandra; Johnson, David

doi:10.1016/s0169-5002(03)91707-7

Cited by 82 publications

(64 citation statements)

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“…Several subset analyses have noted that elderly NSCLC patients with a good performance status tolerate platinum-based combination therapy well and experience survival benefits similar to those of younger patients. 8,9 Therefore, carboplatin-based doublets are used for the treatment of ''fit'' elderly patients with advanced NSCLC in the United States. In a prospectively planned subset analysis of a phase 3 study conducted by the Cancer and Leukemia Group B, the combination of carboplatin and paclitaxel was superior to singleagent therapy with paclitaxel for elderly NSCLC patients.…”

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confidence: 99%

Comparison of outcomes for elderly patients treated with weekly paclitaxel in combination with carboplatin versus the standard 3‐weekly paclitaxel and carboplatin for advanced nonsmall cell lung cancer

Ramalingam

Perry

Rocca

et al. 2008

Cancer

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BACKGROUND.The purpose of this study was to compare the outcomes between elderly (aged ≥70 years) patients treated with paclitaxel on a weekly basis and with carboplatin (every 4 weeks) versus the standard 3‐weekly regimen of carboplatin and paclitaxel for first‐line therapy of advanced nonsmall cell lung cancer.METHODS.Of the 444 patients enrolled, 136 (31%) were aged ≥70 years. Seventy‐two patients were randomized to the weekly schedule (paclitaxel, 100 mg/m2 weekly for 3 of 4 weeks; carboplatin, area under the curve [AUC] = 6 mg/mL·min on Day 1 every 4 weeks), and 64 patients were randomized to the standard schedule (paclitaxel, 225 mg/m2; carboplatin, AUC = 6 mg/mL·min on Day 1 every 21 days). Patients with stable disease or objective response after 4 cycles of therapy were eligible for maintenance therapy with weekly paclitaxel (70 mg/m2, 3 of 4 weeks).RESULTS.The response rate for elderly patients was 26% on the weekly regimen and 19% on the standard schedule. The median survival duration for the weekly and the standard schedules was 37 weeks and 31 weeks, respectively. The 1‐year survival rates were similar at 31% and 33%. Grade 3 to 4 anemia was more common on the weekly schedule (16% vs 6%), whereas grade 3 neuropathy was less common (5.5% vs 9.5%). Nausea and emesis were also less frequent on the weekly schedule.CONCLUSIONS.Efficacy was similar between the weekly regimen and the standard regimen of carboplatin and paclitaxel for elderly patients with advanced NSCLC and may be advantageous based on its favorable tolerability profile. Cancer 2008. © 2008 American Cancer Society.

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Comparison of outcomes for elderly patients treated with weekly paclitaxel in combination with carboplatin versus the standard 3‐weekly paclitaxel and carboplatin for advanced nonsmall cell lung cancer

Ramalingam

Perry

Rocca

et al. 2008

Cancer

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“…One of these has been to perform agespecific retrospective analyses on patients treated in randomised trials evaluating cisplatin-based doublets. Accordingly, several authors have recently reported neither substantial difference in survival, nor greater toxicity, for elderly patients treated with these regimens (Kelly et al, 2001;Rocha Lima et al, 2002;Hensing et al, 2003;Langer et al, 2003). However, these findings have the clear drawback of being extrapolated from studies carried out for different purposes.…”

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confidence: 99%

Gemcitabine with either paclitaxel or vinorelbine vs paclitaxel or gemcitabine alone for elderly or unfit advanced non-small-cell lung cancer patients

Comella

Frasci

Carnicelli³

et al. 2004

Br J Cancer

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The aim of this study was to assess whether a combination of gemcitabine (GEM) with either paclitaxel (PTX) or vinorelbine (VNR) could be more effective than GEM or PTX alone in elderly or unfit advanced non-small-cell lung cancer (NSCLC) patients. A total of 264 NSCLC patients aged 470 years with ECOG performance status (PS)p2, or younger with PS ¼ 2, were randomly treated with: GEM 1200 mg m À2 on days 1, 8 and 15 every 28 days; PTX 100 mg m À2 on days 1, 8 and 15 every 28 days; GEM 1000 mg m À2 plus PTX 80 mg m À2 (GT) on days 1 and 8 every 21 days; GEM 1000 mg m À2 plus VNR 25 mg m À2 (GV) on days 1 and 8 every 21 days. In all arms, an intra-patients dose escalation was applied over the first three courses, provided that no toxicity of WHO grade X2 had previously occurred. At present time, 217 (82%) patients had died. The median (months) and 1-year survival probability were 5.1 and 29% for GEM, 6.4 and 25% for PTX, 9.2 and 44% for GT, and 9.7 and 32% for GV. Multivariate analysis showed that PSp1 (hazard ratio (HR) ¼ 0.67; 95% CI 0.51 -0.90), and doublet treatments (HR ¼ 0.76; 95% CI 0.59 -0.99) were significantly associated with longer survival. Doublets produced no more toxicity than single agents. GT should be considered a reference regimen for elderly NSCLC patients with PSp1.

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“…Few prospective clinical experiences with cisplatin-based chemotherapy in elderly patients with NSCLC have been reported. In some retrospective analyses of large randomized trials with cisplatin or carboplatin-based chemotherapy in patients with advanced NSCLC found no differences in survival between elderly and younger patients, with small increase in toxicity in the elderly, and suggest that advanced age alone should not preclude platin-based chemotherapy for NSCLC, as in our study [7][8][9][10][11].…”

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confidence: 48%

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

Özkaya

Fındık²,

Ag³

et al. 2011

neo

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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.

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O-49 Age-specific subanalysis of ECOG 1594: Fit elderly patietns (70–80 yrs) with NSCLC do as well as younger patients (<70)

Cited by 82 publications

References 0 publications

Comparison of outcomes for elderly patients treated with weekly paclitaxel in combination with carboplatin versus the standard 3‐weekly paclitaxel and carboplatin for advanced nonsmall cell lung cancer

Comparison of outcomes for elderly patients treated with weekly paclitaxel in combination with carboplatin versus the standard 3‐weekly paclitaxel and carboplatin for advanced nonsmall cell lung cancer

Gemcitabine with either paclitaxel or vinorelbine vs paclitaxel or gemcitabine alone for elderly or unfit advanced non-small-cell lung cancer patients

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

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