Prognostic factors in older patients with wild-type epidermal growth factor receptor advanced non-small cell lung cancer: a multicenter retrospective study

Seto, Yurie; Kaneko, Yoshiko; Miyamae, Takako; Fujii, Hiroyuki; Tanaka, Satomi; Shiotsu, Shinsuke; Hiranuma, Osamu; Morimoto, Yoshie; Iwasaku, Masahiro; Yamada, Tadaaki; Uchino, Junichi; Takayama, K.

doi:10.21037/tlcr-20-894

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…[18] Another population-based study in lung cancer patients 80 years or older showed inferior outcomes due to lower treatment rates. [10,11] Tas et al reported poor outcomes of the elderly patients (≥60 years). [5] Our findings revealed a tendency for shorter overall survival in geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies found decreased survival rates in the elderly patients when the cut-off values of age starting from 60 years and over were used. [5,10,11,15] In advanced NSCLC patients with over 70 years has not been studied in detail.…”

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confidence: 99%

“…[8] Older patients with lung cancer have been usually under-represented or excluded by the clinical trials. [8][9][10][11][12][13] Moreover, the side effects of the treatment modalities for lung cancer and limited life expectancy in elderly cancer patients are critical issues that negatively impact lung cancer survival. [4] The ages of the patients might also be an effective factor for the selection of chemotherapeutic drugs.…”

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confidence: 99%

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Survival Evaluation in Patients Over 70 Years of Age With Advanced Stage Non-small Cell Lung Cancer

Ozturk

2023

EJMI

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L ung cancer is one of the most common and lethal cancers worldwide. [1][2][3] Non-small cell lung cancer (NSCLC) that accounts for 85% of all lung cancers is usually diagnosed at advanced stages. [4] It is known that 30 to 40% of lung cancer patients are older than 70 years. [1,4] So, the majority of the new cases of lung cancer are elderly NSCLC patients. [5] Controversy remains about the cut-off point of age for the definition of elderly. Although medical oncologists have considered the age of 65 years for this purpose, it is speculated that a cut-off value of 65 years is not representative of the older population. [6] In the light of those explanations, 70 years have been accepted for the limit of senescence and the geriatric period in some studies.Objectives: Non-small cell lung (NSCLC) cancer is usually seen in elderly patients. The impact of over 70 age on the survival of patients with NSCLC has not been studied. This study aimed to evaluate the impact of demographic and clinical variables on survival in Stage IV the NSCLC elderly patient. Methods: This study was a retrospective cohort analysis of 244 patients with advanced stage NSCLC, between January 2015 and December 2019. The patients were classified as the <70 years and ≥70 years. The primary and secondary outcomes were the overall survival and the impact of the demographics and clinical variables on survival, respectively. Results: The numbers of patients who were <70 and ≥70 years were 136 (55.7%) and 108 (44.3%), respectively. Although the overall survival in patients aged 70 years or older was shorter than that of the younger patients, the difference was statistically insignificant (p=0.236). Weight loss, ≥2 comorbidities and TNM stage IV were significantly associated with shorter overall survival. Conclusion: Weight loss, increased comorbidities and TNM stage IV are the independent risk factors for overall survival in patients with advanced stage of NSCLC. Older age did not found any impact on survival in the study.

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Section: Discussionmentioning

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Survival Evaluation in Patients Over 70 Years of Age With Advanced Stage Non-small Cell Lung Cancer

Ozturk

2023

EJMI

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“…The main reasons for receiving BSC were poor PS, advanced age together with dementia and the patients’ wish. Interestingly, single agent chemotherapy was the selected treatment in the majority of cases receiving an active treatment [ 14 ]. Similar data were reported in a retrospective analysis about the reasons for choosing BSC as initial treatment.…”

Section: Discussionmentioning

confidence: 99%

Selection Criteria and Treatment Outcome for Advanced Non-Small Cell Lung Cancer (NSCLC) Patients Unfit for Platinum-Based First-Line Therapy: Results of the MOON-OSS Observational Trial

Camerini

Conte

Pezzuto

et al. 2022

Cancers

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Limited evidence is available concerning the selection criteria and the outcomes of platinum unfit newly diagnosed advanced NSCLC patients receiving single-agent chemotherapy. We retrospectively collected data on consecutive, stage IIIB-IV, EGFR/ALK negative and PD-L1 < 50% NSCLC patients treated with first-line single agent chemotherapy. Baseline characteristics, outcome measures and toxicities were recorded, as well as criteria according to which treatment selection was made and what percentage of patients did not receive a first-line platinum-based chemotherapy. Two-hundred and twenty-one patients were included. Median age was 79 (range 56–92) years, M/F 165(74.6%)/56(25.4%), ECOG performance status (PS) 0/1/ ≥ 2 23(10.9%)/94(42.5%)/103(46.6%), with a median of two serious comorbidities. A median of 25% (range 10%-30%) of newly diagnosed NSCLC did not receive a first-line platinum combination. Clinical criteria according to which decision was made were older age (76.5%), comorbidities (72%), poor PS (55.2%) and familiar or social issues (10%). Single-agent treatment consisted of oral metronomic vinorelbine (MetV 78.6%), gemcitabine (Gem 10%), oral standard vinorelbine (Vin 8.2%) and other (O 3.2%). Median progression-free survival (PFS) and overall survival (OS) of single agent treatments ranged from 4.5 to 5 months and from 9 to 10.5 months, respectively. All grade toxicities did not differ among single agents, while grade 3–4 toxicities were less frequent with MetV. Up to 30% of newly diagnosed advanced EGFR/ALK negative and PD-L1 < 50% NSCLC patients do not receive a first-line platinum doublet. Main clinical selection criteria were older age (>70 years), comorbidities and poor PS. An oral treatment was frequently proposed with MetV being the most frequent choice according to its safety profile.

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Efficacy and Safety of Docetaxel plus Ramucirumab for Patients with Pretreated Advanced or Recurrent Non-small Cell Lung Cancer: Focus on Older Patients

Onoi,

Yamada,

Morimoto

et al. 2024

Targ Oncol

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Prognostic factors in older patients with wild-type epidermal growth factor receptor advanced non-small cell lung cancer: a multicenter retrospective study

Cited by 4 publications

References 24 publications

Survival Evaluation in Patients Over 70 Years of Age With Advanced Stage Non-small Cell Lung Cancer

Survival Evaluation in Patients Over 70 Years of Age With Advanced Stage Non-small Cell Lung Cancer

Selection Criteria and Treatment Outcome for Advanced Non-Small Cell Lung Cancer (NSCLC) Patients Unfit for Platinum-Based First-Line Therapy: Results of the MOON-OSS Observational Trial

Efficacy and Safety of Docetaxel plus Ramucirumab for Patients with Pretreated Advanced or Recurrent Non-small Cell Lung Cancer: Focus on Older Patients

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