Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin–gemcitabine or carboplatin–paclitaxel: NVALT-3 a phase III study

Biesma, Bonne; Wymenga, A.N.M.; Vincent, Andrew; Dalesio, Otilia; Smit, Hans; Stigt, Jos A.; Smit, Egbert F.; Felius, C.L. van; Putten, John W. G. van; Slaets, Joris P. J.; Groen, Harry J.M.

doi:10.1093/annonc/mdq637

Cited by 90 publications

(43 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, 16 publications from 15 studies [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], involving 4187 patients, were included in the analysis. Crossreferencing yielded no additional results.…”

Section: Search Outcomementioning

confidence: 99%

“…[17,18]. One study included patients with pancreatic tumors undergoing pancreaticoduodenectomy [19], another reported on colorectal cancer patients receiving chemotherapy [30], and finally one analysis included patients with non-small cell lung carcinoma (NSCLC) undergoing chemotherapy [16]. The median number of patients was 202 (range 38-1130) with a reported median or mean age varying from 58 to 78 years.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Physical performance measures for predicting outcome in cancer patients: a systematic review

et al. 2016

View full text Add to dashboard Cite

Background: Decision making regarding cancer treatment is challenging and there is a need for clinical parameters that can guide these decisions. As physical performance appears to be a reflection of health status, the aim of this systematic review is to assess whether physical performance tests (PPTs) are predictive of the clinical outcome and treatment tolerance in cancer patients. Methods: A literature search was conducted on 2 April 2015 in the electronic databases Medline and Embase to identify studies focusing on the association between objectively measured PPTs and outcome. No limitations in language or publication dates were applied. Results: The search retrieved 9680 articles, 16 publications were included involving 4187 patients with various cancer types and different treatments. Reported median or mean age varied from 58 to 78 years. Nine studies used the Timed Up & Go (TUG) test, five the Short Physical Performance Battery (SPPB) and five studies focused on gait speed. Poorer TUG, SPPB and gait speed outcome were associated with decreased survival. TUG, SPPB and gait speed were also associated with treatment-related complications. Furthermore, two studies reported an association between poorer TUG and SPPB outcome with higher rates of functional decline. Conclusion: PPTs appear to show a significant correlation with survival and these tests could be used as a prognostic tool, particular for older adult patients. A less explicit correlation for treatment-related complications and functional decline was also found. To optimize decision making, future research should focus on developing and validating individualized treatment algorithms that incorporate PPTs in addition to cancer-and treatment-related variables.

show abstract

Section: Search Outcomementioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Physical performance measures for predicting outcome in cancer patients: a systematic review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The confirmed response rate was 27% and 19% with a median PFS of 4.7 and 4.5 months and a OS of 8.6 and 6.9 months, respectively. Mean global QoL score at baseline did not differ between both arms without any statistically difference at 18 weeks analysis [15]. The number of QoL responders (12% and 5% in carboplatin plus gemcitabine or paclitaxel, respectively) was not significantly different.…”

Section: Platinum-based Regimensmentioning

confidence: 73%

Elderly Patients with Advanced Non-Small Cell Lung Cancer: What Treatment?

Rossi¹

2011

TOLCJ

View full text Add to dashboard Cite

Advanced non-small cell lung cancer (NSCLC) in elderly patients is an increasingly common problem which the practitioner of oncology must face. There is no consensus on the cut-off age for defining the elderly. However, 70 years may be the most appropriate because the incidence of age-related changes starts to increase after this boundary. Important concerns in evaluating the treatment of elderly patients are the presence of comorbidities and the progressive physiologic reduction of hepatic, renal and bone-marrow functions which could have a negative impact on the degree of toxicity. To individualize treatment choice within a group of elderly NSCLC patients of the same chronological age, it would be important to perform a comprehensive geriatric assessment (CGA) which would allow to subdivide elderly patients into three main categories: fit, pre-frail and frail. Fit older patients have similar prognosis and a similar treatment tolerance and outcome compared to their younger counterparts. On the other hand, pre-frail patients experience significant treatment related toxicity and usually are offered a single-agent chemotherapy whose choice should take into account the expected toxicity profile of the agent, pharmacokinetics, organ function and co-morbidities. For the third category of patients only best supportive care or individualized approaches are recommended.Overall, only prospective trials, specifically addressed to elderly NSCLC patients selected through an adequate CGA at baseline, let us opt for the best treatment to be administered to each elderly patient.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin–gemcitabine or carboplatin–paclitaxel: NVALT-3 a phase III study

Cited by 90 publications

References 33 publications

Physical performance measures for predicting outcome in cancer patients: a systematic review

Physical performance measures for predicting outcome in cancer patients: a systematic review

Elderly Patients with Advanced Non-Small Cell Lung Cancer: What Treatment?

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

Contact Info

Product

Resources

About