Efficacy of modified regimen with attenuated doses of paclitaxel plus carboplatin combination chemotherapy in elderly and/or weak patients with advanced non-small cell lung cancer

Choi, In Sil; Kim, Byung Su; Park, Sook Ryun; Lee, Sang Yoon; Kim, Do Yeun; Kim, Jee Hyun; Lee, Se‐Hoon; Kim, Tae-You; Heo, Dae Seog; Bang, Yung‐Jue; Kim, Noe Kyeong

doi:10.1016/s0169-5002(02)00389-6

Cited by 29 publications

(17 citation statements)

References 5 publications

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“…The results of a retrospective subgroup analysis in elderly patients after cisplatin-based chemotherapy, including taxane, were similar to the outcome of young patients in terms of response, survival and toxicity even though the subjects of those studies were fit elderly patients [20,21]. Prospective studies on combination chemotherapy with taxane and platinum for elderly patients with advanced NSCLC have recently reported favorable results [22][23][24]. Especially, carboplatin has been developed as a less toxic analogue of cisplatin, and it has shown marginal, but consistent activity against NSCLC with favorable toxicity profile.…”

Section: Introductionmentioning

confidence: 67%

A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non-small cell lung cancer

Kim¹,

Kim²,

Lee³

et al. 2010

Lung Cancer

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Section: Introductionmentioning

confidence: 67%

A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non-small cell lung cancer

Kim¹,

Kim²,

Lee³

et al. 2010

Lung Cancer

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“…In another phase II study, an attenuated dose of paclitaxel was administered to elderly patients in combination with carboplatin. This regimen resulted in a response rate of 40% and a median time to progression of 5.5 months 37 .…”

Section: Discussionmentioning

confidence: 99%

Weekly Paclitaxel Combined with Carboplatin Versus the Standard Every 3-Weeks Paclitaxel and Carboplatin for Elderly Patients with Previously Untreated Advanced Non-Small Cell Lung Cancer.

El-Shenshawy

Taema

Elzahaf

et al. 2011

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Paclitaxel and platinum-based chemotherapy is considered to be a standard approach for locally advanced and metastatic Non-Small Cell Lung Cancer (NSCLC). In recent years, paclitaxel on a weekly schedule in combination with carboplatin has been widely used because it is associated with a lower incidence of neuropathy and myelosuppression. Otherwise, only a few studies are available in elderly patients with NSCLC. Purpose: The aim of our study was to evaluate the efficacy and safety of weekly paclitaxel combined with carboplatin compared with the classic 3-weekly schedule of paclitaxel and carboplatin as initial therapy and the feasibility of subsequent maintenance therapy versus observation in elderly patients with locally advanced ( stage IIIB) and metastatic (stage IV) NSCLC. Patients and Methods: Ninty patients ≥ 65 years with stage IIIB-IV NSCLC were randomly assigned to one of the following arms: arm1, paclitaxel 90 mg/m 2 weekly for 3 of 4 weeks with carboplatin (area under the curve {AUC} =6) on day 1 of each 4 week cycle and arm 2, paclitaxel 200 mg/m 2 with carboplatin (AUC=6) on day 1 of each 3-week. After four cycles of chemotherapy, those with objective response or stable disease were randomized to weekly paclitaxel (70mg/m 2 , 3 of 4 weeks) or observation as maintenance therapy. Primary end point was response while second end points included survival and toxicity. Results: Eighty-six patients were evaluable for response, overall responses were recorded in 42.9% in arm 1 versus 31.8% in arm 2; stable disease was 38.1% in arm 1 versus 27.3% in arm 2 and progressive disease was 19% in arm 1 versus 40.9% in arm 2. The median time to progression and median survival times were 7 months and 10.8 months in arm 1 versus 5.6 months and 9 months in arm 2, respectively. The 1-year survival rates were 47.6% in arm 1 versus 36.4% in arm 2. Grade 3/4 anemia was more common in arm 1 (23.8%) than arm 2 (9.1%). Grade 3/4 neutropenia and febrile neutropenia occurred in 14.3% and 4.7% in arm 1 versus 22.7% and 9.1% in arm 2. Grade 2/3 neuropathy occurred in 4.7 % in arm 1 versus 13.6% in arm 2. Conclusions: Efficacy was similar between the weekly regimen and the standard regimen of carboplatin and paclitaxel for elderly patients with advanced NSCLC and may be advantageous based on its favorable tolerability profile.

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“…More favourable results were reported for the combination of low-dose carboplatin (AUC 4) and gemcitabine accompanied by acceptable toxicity [47] . Modified carboplatin/paclitaxel schedules reached in many trials 70% RR and 14 mo MST [10,[48][49][50][51][52][53] . Recently IFCT-0501 confronted attenuated carboplatin-paclitaxel schedule vs standard single agent monotherapy.…”

Section: Bevacizumabmentioning

confidence: 99%

Advanced non-small cell lung cancer in elderly patients: A review

Buffoni¹

2015

WJR

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Over 50% of patients diagnosed with non-smallcell lung cancer (NSCLC) are 65 years old while 30% exceed 70 years old. Comparing elderly patients to their younger counterpart they poorly tolerate chemotherapy due to progressive reduction of organ function and age-related co-existing pathologies. Due to this reason elderly are usually excluded from platinum-based chemotherapy, which still represent the standard of care for advanced NSCLC. In every-day practice, single-agent schedule with a third-generation drug is the recommended option for elderly patients with advanced NSCLC. A modest increase in toxicity for elderly patients has been demonstrated by subgroup analyses concluding for platinum-based combination chemotherapy being similar in young patients and fit elderly. Even though the cited evidence, feasibility of chemotherapy based on platinum remains an open question. Prospective randomised trials are warranted in order to change guide lines and give the clinicians a new therapeutic option. Recent emerging role of molecular target in selecting patients for new targeted therapies suggest dedicated trials for elderly patients. The same is for more accurate evaluation of elderly patients with increasing evidence for a comprehensive geriatric assessment as a valid tool for customized treatment in NSCLC elderly patients. Suitable evidences for the treatment of elderly patients affected by advanced NSCLC together with more appropriate and validated tools for patients selection are reviewed along the manuscript.

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Efficacy of modified regimen with attenuated doses of paclitaxel plus carboplatin combination chemotherapy in elderly and/or weak patients with advanced non-small cell lung cancer

Cited by 29 publications

References 5 publications

A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non-small cell lung cancer

A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non-small cell lung cancer

Weekly Paclitaxel Combined with Carboplatin Versus the Standard Every 3-Weeks Paclitaxel and Carboplatin for Elderly Patients with Previously Untreated Advanced Non-Small Cell Lung Cancer.

Advanced non-small cell lung cancer in elderly patients: A review

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