Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Cisplatin-Based Therapy for the Treatment of Elderly Patients with Non-Small-Cell Lung Cancer: a Retrospective Analysis of a Single Institution

  • Published : 2012.05.30
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Abstract

Background: In spite of the fact that platinum-based doublets are considered the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC), no elderly-specific platinum based prospective phase III regimen has been explored. The aim of this retrospective singlecenter study was to evaluate the efficacy and side effects of cisplatin-based therapy specifically for the elderly. Methods: Patients receiving platinum-based treatment were divided into three groups. In the first group (GC), Gemcitabine was administrated at 1000 $mg/m^2$ on days 1, 8 and cisplatin was added at 75 $mg/m^2$ on day 1. In the second group (DC), 75 $mg/m^2$ docetaxel and cisplatin were administered on day 1. The third group (PC) received 175 mg of paclitaxel and 75 mg of cisplatin on day 1. These treatments were repeated every three weeks. Result: GC arm had 36, the DC arm 42 and the PC arm 29 patients. Grade III-IV thrombocytopenia was higher in the GC arm (21.2% received GC, 2.8% received DC, and 3.8% received PC), while sensory neuropathy was lower in patients with GC arm (3.0%, 22.2%, and 23.1% received GC, DC and PC, respectively). There were no statistically significant difference in the response rates among the three groups (p>0.05). The median Progression-free survival (PFS) was 5.0 months and the median Overall survival (OS) in each group was 7.1, 7.4 and 7.1 months, respectively (p>0.05). Conclusion: The response rate, median PFS and OS were similar among the three treatment arms. Grade III-IV thrombocytopenia was higher in the GC arm, while the GC regimen was more favorable than the other cisplatin-based treatmetns with regard to sensory neuropathy.

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References

  1. Ansari R, Gonin R, Socinski M (2007). Eldelry subgroup analysis of a radnomized phase 3 trial of gemcitabine (G) in combination with carboplatin (Cb) or paclitaxel (P) compared to paclitaxel plus carboplatin in advanced (stage IIIB, IV) non-small cell lung cancer. Proc Am Soc Clin Oncol, 25, 7665.
  2. Ansari RH, Socinski MA, Edelman MJ, et al (2011). A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced nonsmall cell lung cancer. Crit Rev Oncol Hematol, 78,162-71. https://doi.org/10.1016/j.critrevonc.2010.03.003
  3. Belani CP, Fossella F (2005). Elderly subgroup analysis of a randomized phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for first-line treatment of advanced nonsmall cell lung carcinoma (TAX 326). Cancer, 104, 2766-74. https://doi.org/10.1002/cncr.21495
  4. Deppermann KM (2011). Influence of age and comorbidities on the chemotherapeutic management of lung cancer. Lung Cancer, 33, 115-20.
  5. Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer (1999). The elderly lung cancer vinorelbine Italian study group. J Natl Cancer Inst, 91, 66-72. https://doi.org/10.1093/jnci/91.1.66
  6. Havlik RJ, Yancik R, Long S, et al (1994). The national institute on aging and the national cancer institute SEER collaborative study on comorbidity and early diagnosis of cancer in the elderly. Cancer, 74, 2101-6. https://doi.org/10.1002/1097-0142(19941001)74:7+<2101::AID-CNCR2820741718>3.0.CO;2-M
  7. Hensing TA, Peterman AH, Schell MJ, et al (2003). The impact of age on toxicity, response rate, quality of life, and survival in patients with advanced, stage IIIB or IV nonsmall cell lung carcinoma treated with carboplatin and paclitaxel. Cancer, 98, 779-88. https://doi.org/10.1002/cncr.11548
  8. Jatoi A, Hillman S, Stella P, et al (2005). Should elderly nonsmall- cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the north central cancer treatment group. J Clin Oncol, 23, 9113-9. https://doi.org/10.1200/JCO.2005.03.7465
  9. Kelly K, Giarritta S, Akerley W (2001). Should older patients (Pts) receive combination chemotherapy for advanced stage non-small cell lung cancer (NSCLC)? An analysis of southwest oncology trials 9509 and 9308. Proc Am Soc Clin Oncol, 20, 1313.
  10. Langer C, Vangel M, Schiller HJ (2003). Age-specific subanalysis of ECOG 1594: fit elderly patients (70-80 YRS) with NSCLC do as well as younger pts (<70). Proc Am Soc Clin Oncol, 22, 2571.
  11. Langer CJ, Manola J, Bernardo P, et al (2002). Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of eastern cooperative oncology group 5592, a randomized trial. J Natl Cancer Inst, 94, 173-81. https://doi.org/10.1093/jnci/94.3.173
  12. Maione P, Rossi A, Sacco PC, et al (2010). Treating advanced non-small cell lung cancer in the elderly. Ther Adv Med Oncol, 2, 251-60. https://doi.org/10.1177/1758834010366707
  13. Nurgalieva Z, Xia R, Liu CC, et al (2010). Risk of chemotherapyinduced peripheral neuropathy in large population-based cohorts of elderly patients with breast, ovarian, and lung sancer. Am J Ther, 17, 148-58. https://doi.org/10.1097/MJT.0b013e3181a3e50b
  14. Pallis AG, Gridelli C, Van Meerbeeck JP, et al (2010). EORTC elderly task force and lung cancer group and International society for geriatric oncology (SIOG) experts' opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Oncol, 21, 692-706. https://doi.org/10.1093/annonc/mdp360
  15. Parkin DM (2001). Global cancer statistics in the year 2000. Lancet Oncol, 2, 533-43. https://doi.org/10.1016/S1470-2045(01)00486-7
  16. Ramalingam S, Perry MC, La Rocca RV, et al (2008). 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. Cancer, 113, 542-6. https://doi.org/10.1002/cncr.23583
  17. Repetto L, Venturino A, Fratino L, et al (2003). Geriatric oncology: a clinical approach to the older patient with cancer. Eur J Cancer, 39, 870-80. https://doi.org/10.1016/S0959-8049(03)00062-5
  18. Rocha Lima CM, Herndon JE, Kosty M, Clamon G, Green MR (2002). Therapy choices among older patients with lung carcinoma: an evaluation of two trials of the cancer and leukemia group B. Cancer, 94, 181-7. https://doi.org/10.1002/cncr.10174
  19. Schild SE, Stella PJ, Geyer SM, et al (2003). The outcome of combinedmodality therapy for stage III non-small-cell lung cancer in the elderly. J Clin Oncol, 21, 3201-6. https://doi.org/10.1200/JCO.2003.12.019
  20. Sederholm C, Hillerdal G, Lamberg K, et al (2005). Phase III trial of gemcitabine plus carboplatin versus singleagent gemcitabine in the treatment of locally advanced or metastatic non-small-cell lung cancer: the Swedish lung cancer study group. J Clin Oncol, 23, 8380-8. https://doi.org/10.1200/JCO.2005.01.2781
  21. Sequist LV, Lynch TJ (2003). Aggressive treatment for the fit elderly with non-small-cell lung cancer? Yes! J Clin Oncol, 21, 3186-8. https://doi.org/10.1200/JCO.2003.04.002
  22. Shepherd FA (1993). Screening, diagnosis, and staging of lung cancer. Curr Opin Oncol, 5, 310-22. https://doi.org/10.1097/00001622-199303000-00010
  23. Walling J (1994). Chemotherapy for advanced non-small-cell lung cancer. Respir Med, 88, 649-57. https://doi.org/10.1016/S0954-6111(05)80061-7

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