Single-Agent Versus Combination Chemotherapy in Advanced Non–Small-Cell Lung Cancer: The Cancer and Leukemia Group B (study 9730)

Abstract

Combination chemotherapy improves response rate and failure-free survival compared with single-agent therapy, but there was no statistically significant difference in the primary end point of overall survival. The results in elderly patients were similar to younger patients. Performance status 2 patients had a superior outcome when treated with combination chemotherapy.

What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis

“…Five publications [18,19,[21][22][23] are about randomized phase III trials and one was a randomized phase II trial [24]. Four studies [18,19,21,24] were specifically devoted to PS2 patients, while two trials [22,25] reported subgroup analysis for PS2 patients (18 and 20%, respectively) within larger randomized phase III trials.…”

“…Four studies [18,19,21,24] were specifically devoted to PS2 patients, while two trials [22,25] reported subgroup analysis for PS2 patients (18 and 20%, respectively) within larger randomized phase III trials. All trials compared a platinumbased doublet with single-agent chemotherapy; four of these [18,21,22,24] compared carboplatin-based doublet with single agent chemotherapy: carboplatin plus pemetrexed vs pemetrexed alone [18], carboplatin plus gemcitabine vs gemcitabine alone [21,24], carboplatin plus paclitaxel vs paclitaxel alone [22,25]; the other two trials compared cisplatin plus gemcitabine with gemcitabine alone [19] and cisplatin plus vinorelbine or vindesine with vinorelbine alone [23]. In nearly every trial characteristics were well balanced between two arms.…”

“…The extracted data, including number of patients, PS, age, histology, stage, chemotherapy regimens, and outcomes, were reported in Table 2. Data about ORR [18,19,21,22,24] and 1y-SR [18,[21][22][23][24] were available from five studies. Finally, data about toxicity were available from 4 trials [18,19,21,24].…”

“…Some included studies were specifically devoted to PS2 patients [18,19,21,24], 2 studies were not exclusively devoted to this subset of patients [22,23]. The CALGB trial [22] compared carboplatin-paclitaxel with paclitaxel alone in 584 patients with advanced NSCLC.…”

Concurrent chemoradiotherapy with weekly nedaplatin versus radiotherapy alone in elderly patients with non-small-cell lung cancer

“…There has been a significant increase in the occurring of NSCLC, with higher life expectancy worldwide, due to the relative accumulated increase in danger of tumor with age. The elderly patient is a special group regarded as 60 years or older in epidemiology according to their poorer body status, increased appearance of chronic disease complications, insensitive to therapy reaction [4]. Hurria and Siegel [5,6] displayed that the incidence of NSCLC in elderly patients was high, in addition, the morbidity and mortality rates of patients-older than 60 years included 50% in patients-age range from 65 to 70 years and 30-40% of patients-older which than 70 years were higher.…”