An open multicenter phase II trial of weekly docetaxel for advanced-stage non-small-cell lung cancer in elderly patients with significant comorbidity and/or poor performance status: The GFPC 02-02b study

A multicenter phase II randomized trial of gemcitabine followed by erlotinib at progression, versus the reverse sequence, in vulnerable elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0505 study)

“…Our results for first-line gemcitabine monotherapy in this population compare well with published data [4,8,[21][22][23][24][25], but remain disappointing. However, it is noteworthy that our population included a large proportion of patients with PS = 2 (respectively 29% and 18% in arms A and B) and relatively high comorbidity scores.…”

The safety and efficacy of EGFR TKIs monotherapy versus single-agent chemotherapy using third-generation cytotoxics as the first-line treatment for patients with advanced non-small cell lung cancer and poor performance status

“…1). A total of 1425 patients, 330 treated with EGFR TKIs and 1095 treated with single-agent regimens, were included in this study [10][11][12][13][14][15][16][17][18][19][28][29][30][31][32].…”

“…We conducted this pooled analysis and systematic review to compare the risk and benefit profiles of EGFR TKIs and single-agent chemotherapy in this special population. First, we found that the study population was heterogeneous because a small number of good PS elderly patients had been enrolled in 5 chemotherapy trials [10,[12][13][14]18]. Although elderly and poor PS patients have shared several characters, such as the reduced organ function and higher prevalence of comorbid disorders, a small number of good PS elderly patients could change the outcomes for all trials participants because the enormous differential in efficacy of treatment between good PS elderly and their poor PS counterpart [46,47].…”

“…Although, there is no consensus on standard treatment for these patients, single-agent chemotherapy appears to be a reasonable choice for them. This conclusion arises from the efficacy and tolerability observed with third-generation cytotoxics (gemcitabine, vinorelbine, taxanes) as single-agent therapy in both phase II and III trials [10][11][12][13][14][15][16][17][18][19]. However, this treatment appears only justified for patients with a PS of 2, there is no recommended treatment for PS 3 or 4 ANSCLC patients [20][21][22][23].…”

Update on nonsmall cell lung cancer

“…Some efforts have been made to predict febrile neutropenia risk with prediction models [113]. Strategies to prevent deaths from toxicity in the most exposed elderly fragile population have included either prophylactic use of granulocyte-colony stimulating factors when febrile neutropenia risk is .20%, weekly schedules that have been proved to lower haematological grade 3/4 adverse effects without penalising efficacy in this population [112,114], or use of non-platinum doublets [115,116].…”