Efficacy and treatment tolerance in older patients with NSCLC: a meta-analysis of five phase III randomized trials conducted by the Hellenic Oncology Research Group

• Published in: Annals of oncology Vol. 22; no. 11; pp. 2448 - 2455
• Main Authors: Pallis, A.G., Karampeazis, A., Vamvakas, L., Vardakis, N., Kotsakis, A., Bozionelou, V., Kalykaki, A., Hatzidaki, D., Mavroudis, D., Georgoulias, V.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.11.2011; Oxford University Press
• Subjects: Age Factors; Aged; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Clinical Trials, Phase III as Topic - methods; Deoxycytidine - administration & dosage; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Docetaxel; Female; geriatric oncology; Humans; Lung Neoplasms - drug therapy; Male; Medical sciences; meta-analysis; Multicenter Studies as Topic; NSCLC; older; Pharmacology. Drug treatments; Pneumology; Randomized Controlled Trials as Topic - methods; Survival Rate; Taxoids - administration & dosage; Taxoids - adverse effects; Taxoids - therapeutic use; Tumors of the respiratory system and mediastinum; Vinblastine - administration & dosage; Vinblastine - adverse effects; Vinblastine - analogs & derivatives; Vinorelbine; meta-analysis; geriatric oncology; older; NSCLC; Human; Phase III trial; Lung disease; Respiratory disease; Lung cancer; Treatment efficiency; Tolerance; Research; Malignant tumor; non-small cell lung carcinoma; Metaanalysis; Chemotherapy; Randomization; Cancerology; Treatment; Bronchus disease; Elderly; Age; Cancer; Geriatrics
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdq772

Approximately 50% of newly diagnosed cases of non-small-cell lung cancer (NSCLC) are observed in patients >65 years, while 30%–40% of cases occur in patients >70 years. The objective of the current study was to determine (i) the number of elderly (>70 years) patients with advanced/metastatic NSCLC enrolled in phase III trials of the Hellenic Oncology Research Group, (ii) the treatment-related toxicity observed in these patients compared with their younger counterparts, and (iii) the differences in terms of response rate, time to tumor progression (TTP), and overall survival (OS) between younger and older patients. Pooled data from five clinical trials including 1845 patients were analyzed; 1421 (77%) and 424 (23%) were <70 years and ≥70 years, respectively. No difference was observed in terms of the overall response rate and TTP. There was an OS difference between young and older patients, with higher risk for death in older patients. However, when the analysis was carried out after omitting a trial that showed a different trend, no difference was observed. Older patients experienced higher toxicity. This report supports the feasibility of chemotherapy treatment for older NSCLC patients. Optimization of treatment of older NSCLC patients requires the design of prospective older-specific phase III trials for these patients.