Randomized phase III trial comparing weekly docetaxel (D)-cisplatin (P) combination with triweekly D alone in elderly patients (pts) with advanced non-small cell lung cancer (NSCLC): An intergroup trial of JCOG0803/WJOG4307L.

Abe, Takashige; Yokoyama, Akira; Takeda, Koji; Ohe, Y.; Kudoh, Shoji; Ichinose, Yukito; Okamoto, Hiroaki; Yamamoto, Norio; Yoshioka, Hiroshige; Minato, Koichi; Sawa, Toshiyuki; Iwamoto, Yasuo; Sasaki, Hideo; Mizusawa, Junki; Shibata, Taro; Nakamura, Saburo; Ando, Masahiro; Nakagawa, Ken; Saijo, N.; Tamura, Tomohide

doi:10.1200/jco.2011.29.15_suppl.7509

Cited by 27 publications

(27 citation statements)

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“…6,7,11 Recently, two randomized Phase III trials evaluated the efficacy of was terminated early (JCOG0803/WJOG4307L). 13 In this trial, the combination regimen was again more toxic. Indeed, the American Society of Clinical Oncology states in their guidelines that the evidence does not support the selection of a specific first-line chemotherapy drug or combination treatment based on age alone.…”

Section: Discussionmentioning

confidence: 78%

Phase I and II Trials of Vinorelbine With Carboplatin for Patients 75 Years of Age or Older With Previously Untreated Non–Small-Cell Lung Cancer

Takatani

Nakamura

Nagashima

et al. 2012

Clinical Lung Cancer

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Section: Discussionmentioning

confidence: 78%

Phase I and II Trials of Vinorelbine With Carboplatin for Patients 75 Years of Age or Older With Previously Untreated Non–Small-Cell Lung Cancer

Takatani

Nakamura

Nagashima

et al. 2012

Clinical Lung Cancer

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“…Because of these limitations it could not be concluded that platinum-based doublet therapy should be considered as first-line treatment in patients aged >70 years of age. (3) The results of the present systematic review may be influenced by four large trials, 7,8,19,22 which may be responsible for the lack of survival benefit seen in East Asian patients. It is possible that even after pooling the data, the power may have been inadequate to detect a difference.…”

Section: Discussionmentioning

confidence: 99%

“…Eleven publications were finally included for analyses (Figure 1; 13 trials and 2 782 patients. [5][6][7][8][19][20][21][22][23][24][25] All included trials, together with their related Jadad scale scores, are shown in Table 1.…”

Section: Study Selectionmentioning

confidence: 99%

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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

Wang

Tian

et al. 2015

J Int Med Res

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Objective: To perform a systematic review and meta-analysis comparing doublet versus single agent therapy in elderly patients with advanced nonsmall-cell lung cancer (NSCLC). Methods: PubMed Õ and Cochrane databases, and American Society of Clinical Oncology, World Congress of Lung Cancer, and European Society of Medical Oncology abstracts were searched. Endpoints were overall survival (OS), 1-year survival rate (1-year SR), overall response rate (ORR), and grade 3/4 adverse events. Subgroup analyses were based on chemotherapy regimens and race. Results: Out of 11 studies (13 randomized trials; n ¼ 2782), doublet therapy was associated with significantly increased OS (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.83, 0.95), 1-year SR (risk ratio [RR] 1.15, 95% CI 1.04, 1.28), and ORR (RR 1.39, 95% CI 1.39, 1.86) versus singleagents. Chemotherapy regimen-based subgroup analyses favoured platinum-based doublet therapy for OS (RR 0.71, 95% CI 0.60, 0.84), 1-year SR (RR 1.28, 95% CI 1.11, 1.47), and ORR (RR 1.88, 95% CI 1.49, 2.38). Race-based subgroup analyses revealed increased benefit from doublet therapy in Asian populations for ORR (RR 1.70, 95% CI 1.29, 2.23) but not increased survival benefit. Higher incidences of grade 3/4 anaemia (RR 2.23, 95% CI 1.61, 3.09), thrombocytopenia (RR 2.47, 95% CI 1.17, 5.20), and fatigue (RR 1.36, 95% CI 1.06, 1.74) were observed with doublet versus single-agent therapy. Conclusions: Doublet therapy was associated with significantly increased OS, 1-year SR and ORR compared with single agent therapy. Race may be considered when choosing doublet versus singleagent therapy as first-line treatment of NSCLC in elderly patients.

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“…The first study compared single-agent therapy with docetaxel versus carboplatin plus docetaxel and was prematurely closed after inclusion of 63 patients because of the demonstration in a preplanned interim analysis of superiority of the doublet in the 70-74 year age category [Tsukada et al 2007]. The second study was presented at the American Society of Clinical Oncology conference in 2011 [Abe et al 2011] and compared docetaxel alone on a 3-weekly schedule versus weekly cisplatin plus docetaxel. This study failed to demonstrate any advantage of the addition of weekly cisplatin to single-agent docetaxel.…”

Section: Geriatric Assessmentmentioning

confidence: 99%

Therapeutic options in older patients with metastatic non-small cell lung cancer

Quoix

2012

Ther Adv Med Oncol

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Abstract:The increase in life expectancy, with its concomitant increase in the risk of cancer, has led to an increased incidence of lung cancer in older people. The median age at diagnosis of lung cancer is between 63 and 70 years. For a long time, there has been a pessimistic attitude by doctors, patients and their relatives and thus an undertreatment of older patients. Older patients have some specific differences compared with younger patients: more comorbidities with concomitant medications that may interfere with chemotherapy, geriatric syndromes, frailty and so on. The first trial devoted to older patients with advanced nonsmall cell lung cancer (NSCLC) was a comparison between vinorelbine and best supportive care. There was a significant benefit of survival in the chemotherapy arm. Doublet therapy with gemcitabine plus vinorelbine did not give better results than either of these drugs alone. Thus, the recommendations for the treatment of older patients with advanced NSCLC were to give monotherapy. In some clinical trials not dedicated to older patients it appeared that patients might benefit from platinum-based doublet therapy like their younger counterparts. A randomized trial conducted by the French intergroup, IFCT, in patients aged at least 70 years comparing vinorelbine or gemcitabine alone with monthly carboplatin combined with weekly paclitaxel demonstrated that there was a highly significant benefit of survival in the doublet arm. This study resulted in a modification of the recommendations on the treatment of older patients with advanced NSCLC.

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Randomized phase III trial comparing weekly docetaxel (D)-cisplatin (P) combination with triweekly D alone in elderly patients (pts) with advanced non-small cell lung cancer (NSCLC): An intergroup trial of JCOG0803/WJOG4307L.

Cited by 27 publications

References 0 publications

Phase I and II Trials of Vinorelbine With Carboplatin for Patients 75 Years of Age or Older With Previously Untreated Non–Small-Cell Lung Cancer

Phase I and II Trials of Vinorelbine With Carboplatin for Patients 75 Years of Age or Older With Previously Untreated Non–Small-Cell Lung Cancer

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

Therapeutic options in older patients with metastatic non-small cell lung cancer

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