Chemotherapy in elderly patients with advanced non-small cell lung cancer

Quoix, Élisabeth; Westeel, Virginie; Zalcman, Gérard; Milleron, B.

doi:10.1016/j.lungcan.2011.06.006

Cited by 20 publications

(8 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although most RCTs were initially focused on younger adults, there is growing evidence supporting the use of chemotherapy and RT in elderly patients with advanced NSCLC [9, 21–31]. The first RCT specifically focused on older patients (n=191), conducted by the Elderly Lung Cancer Vinorelbine Italian Study Group (ELVIS), found that single-agent chemotherapy, compared to supportive care, offered a survival benefit [26].…”

Section: Discussionmentioning

confidence: 99%

Treatment Toxicity in Elderly Patients With Advanced Non–Small Cell Lung Cancer

Kale

Mhango

Gomez

et al. 2017

American Journal of Clinical Oncology

View full text Add to dashboard Cite

Objectives Toxicity is a main concern limiting the use of chemotherapy and radiotherapy (RT) for elderly patients with non-small cell lung cancer (NSCLC). The objective of this study was to assess the rates of treatment-related toxicity among elderly stage IIIB and IV NSCLC patients. Materials and Methods We used the Surveillance, Epidemiology and End Results registry linked to Medicare records to identify 2,596 stage IIIB and 14,803 stage IV NSCLC patients ≥70 years of age, diagnosed in 2000 or later. We compared rates of toxicity requiring hospitalization according to treatment (chemotherapy, RT, or chemoradiation [CRT]) in unadjusted and adjusted models controlling for selection bias using propensity scores. Results Among stage IIIB patients, rates of any severe toxicity were 10.1%, 23.8%, 30.4%, and 39.2% for patients who received no treatment, RT, chemotherapy alone, and CRT, respectively. In stage IV patients, rates of any severe toxicity were 31.5 % vs. 13.5% among those treated with and without chemotherapy, respectively. In stage IIIB patients treated with CRT, the most common toxicities was esophagitis (odds ratio [OR]:48.5, 95% confidence interval [CI]:6.7–350.5). Among stage IV patients treated with chemotherapy, the risk of toxicity was highest for neutropenia (OR: 8.4, 95% CI: 6.1–11.5). Conclusion Toxicity was relatively common among stage IIIB patients with up to a 6 fold increase in elderly individuals treated with CRT and a 4 fold increase in toxicities among stage IV patients. This information should be helpful to guide discussions about the risk-benefit ratio of chemotherapy and RT in elderly patients with advanced NSCLC.

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment Toxicity in Elderly Patients With Advanced Non–Small Cell Lung Cancer

Kale

Mhango

Gomez

et al. 2017

American Journal of Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Considering the results of this phase II and IFCT-0501 trials, they selected the CP regimen as a candidate for a future phase III trial in elderly patients with advanced NSCLC [ 23 ]. Although monotherapy with the third-generation agents has been regarded as the preferred treatment option for elderly patients with NSCLC, Quoix et al [ 24 ] recently reported the results of IFCT-0501, a phase III study comparing a similar CP regimen with monotherapy with either vinorelbine or gemcitabine in an elderly population. They demonstrated a significant superiority of the CP regimen in terms of the efficacy (overall survival); however, severe toxicity in the CP arm, including a treatment-related death rate of 4.4%, was observed [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although monotherapy with the third-generation agents has been regarded as the preferred treatment option for elderly patients with NSCLC, Quoix et al [ 24 ] recently reported the results of IFCT-0501, a phase III study comparing a similar CP regimen with monotherapy with either vinorelbine or gemcitabine in an elderly population. They demonstrated a significant superiority of the CP regimen in terms of the efficacy (overall survival); however, severe toxicity in the CP arm, including a treatment-related death rate of 4.4%, was observed [ 24 ]. In this study, we found an association between toxicity and chemotherapy regimen as the previous studies in a multivariate logistic regression analysis, and docetaxel monotherapy might be more toxic than the combination therapy.…”

Section: Discussionmentioning

confidence: 99%

Genetic Variations of Drug Transporters Can Influence on Drug Response in Patients Treated with Docetaxel Chemotherapy

et al. 2014

View full text Add to dashboard Cite

PurposeDose-limiting toxicities of docetaxel are widely considered to be neutropenia, anemia, skin toxicity, and nausea. One of the factors that limit the use of docetaxel is its unpredictability of inter-individual variation in toxicity.Materials and MethodsIn order to identify the genetic factors that affect the risk of docetaxel-induced toxicities, we recruited patients who received docetaxel chemotherapy. We genotyped 92 patients with single-nucleotide polymorphisms (SNPs) in 5 genes: CYP3A4 (CYP3A4*1B, CYP3A4*18, and CYP3A4*3), CYP3A5 (CYP3A5*2 and CYP3A5*3), ABCB1 (C1236T, G2677G/T, and C3435T), SLCO1B3 (rs11045585), and ABCC2 (rs12762549).ResultsOut of 92 patients, 70 had grade 3 or 4 neutropenia; 4 had grade 1 or 2; and 18 had no toxicity (76.1%, 4.3%, and 19.6%, respectively). The findings of the SNP analysis showed that patients with TT genotype of ABCB1 3435C>T polymorphism showed significantly higher risk of neutropenia and anemia (p=0.029 and p=0.044, respectively). There were significant associations between docetaxel-induced leucopenia and 2677G/T of ABCB1 and rs12762549 of ABCC2 (p=0.025 and p=0.028, respectively). In a multivariate analysis, we observed that patients carrying 2677G>T in ABCB1might be associated with higher risk of chemo-resistance when treated with docetaxel (odds ratio [OR], 6.48; confidence interval, 1.92 to 21.94; p=0.003). In a subgroup analysis of non-small cell lung cancer patients, a significant association of tumor response with G2677T/A (OR, 4.54) in ABCB1 and SLCO1B3 (OR, 9.44) was observed.ConclusionOur data suggest that ABCB1 (2677G/T) and SLCO1B3 (rs11055585) might be major genetic predictors of docetaxel-related toxicities in patients receiving docetaxel chemotherapy.

show abstract

“…The articles analyzed the efficacy of platinum, non-platinum or combination therapeutic regimens while also advocating towards specific treatment modalities. Nine studies advocate for combination therapy as an effective treatment regimen for first-line NSCLC [7][8][9][10][11][12][13][14][15], five studies advocate towards non-platinum based therapy as an effective and safer regimen [8,[16][17][18][19], one study concludes that non-platinum based therapy is an effective regimen compared to combination therapy in first-line NSCLC [20], two studies conclude that both non-platinum based regimens and combination therapy show an equal efficacy [21,22], three therapies indicate similar efficacy between platinum-based and non-platinum based regimens [23][24][25], two therapies indicate that the efficacy of non-platinum based therapy is similar to the efficacy of other treatment regimens [26,27], one study states that platinum-based regimens showed a higher efficacy and response rate than non-platinum based regimens [28], 12 studies advocate for non-platinum based regimens as a second line treatment regimen [29][30][31][32][33][34][35][36][37][38][39][40], and two studies advocate towards combination therapy for second-line treatment [41,42]. Most of the articles lean towards the use of combination therapy for first-line treatment and non-platinum based therapy for second-line treatment.…”

Section: A Brief Analysis Of Resultsmentioning

confidence: 99%

First and Second Line Chemotherapeutic Regimens for Non-Small Cell Lung Carcinomas - The Efficacy of Platinum, Non-Platinum and Combination Therapy: A Literature Review

Michael

Ainsley

Joseph

et al. 2020

Cureus

View full text Add to dashboard Cite

Non-small cell lung carcinomas (NSCLC) account for a major part of all lung cancer diagnoses. The current literature review is aimed to analyze the varied chemotherapeutic treatment regimens available and to provide a standard for their use in the present and future scenarios. The current literature review focuses on platinum, non-platinum and combination therapeutic modalities, in the first and second line setting. The review also ensures that docetaxel and/or gemcitabine is a part of the study. A PubMed search for NSCLC identified 70,077 articles. A total of 36 research articles were obtained following the application of keywords and inclusion/exclusion criteria to narrow down our search to meet with the research objective. These articles consider NSCLC and chemotherapeutic treatment modalities as its primary endpoint. These 36 articles included 15 randomized clinical trials, five randomized control trials, five retrospective cohort studies, one case-control study, six review articles and four observational studies. Our analysis shows that there is an increasing potential for the use of non-platinum based drugs in the clinical setting with an efficacy that is at par with that of platinum-based treatment modalities. In fact, the studies have proven a greater advantage with the use of combination therapy (non-platinum + platinum), which can be readily applied as an alternative in the clinical setting while the use of non-platinum drugs (other than docetaxel) as a monotherapy or in combination with other non-platinum based drugs does require further research.

show abstract

Chemotherapy in elderly patients with advanced non-small cell lung cancer

Cited by 20 publications

References 40 publications

Treatment Toxicity in Elderly Patients With Advanced Non–Small Cell Lung Cancer

Treatment Toxicity in Elderly Patients With Advanced Non–Small Cell Lung Cancer

Genetic Variations of Drug Transporters Can Influence on Drug Response in Patients Treated with Docetaxel Chemotherapy

First and Second Line Chemotherapeutic Regimens for Non-Small Cell Lung Carcinomas - The Efficacy of Platinum, Non-Platinum and Combination Therapy: A Literature Review

Contact Info

Product

Resources

About