Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer. Issue 6 (November 2013)

• Record Type: Journal Article
• Authors: Piacentini, Paolo; Greco, Filippo; Mercanti, Anna; Trolese, Anna Rita; Durante, Emilia; Moratello, Giacomo; Tognetto, Michele; Furini, Lara; Giuliani, Jacopo; Bonetti, Andrea
• Is Part Of: Tumori. Volume 99:Issue 6(2013)
• Page Start: 650
• Page End: 655
• Publication Date: 2013-11
• Subjects: elderly -- non-small cell lung cancer -- platinum-based chemotherapy; Cancer -- Periodicals; 616.994
• DOI: 10.1177/030089161309900602
• Languages: English
• ISSNs: 0300-8916

Abstract

Aims and background: More than 50% of patients with advanced non-small cell lung cancer are diagnosed in the elderly. Few prospective clinical data with cisplatin-based chemotherapy are available, and some authors have suggested that a non-platinum single agent should be the preferred form of cure in these patients. The aim of the study was to evaluate the efficacy and safety of first-line chemotherapy based on platinums (carboplatin or cisplatin) plus a third generation compound (vinorelbine or gemcitabine) in elderly patients with advanced non-small cell lung cancer in daily clinical practice. Methods: A retrospective analysis of consecutive elderly (≥70 years of age) patients with advanced non-small cell lung cancer treated at our Medical Oncology Unit from February 2005 to September 2011 was performed. Results: A total of 249 cycles of chemotherapy was administered to 62 patients (median age, 72 years; range, 70–81) presenting a median Charlson comorbidity index of 1 and a good ECOG PS (0–1, 52 patients; 2, 10 patients). The median number of cycles/patient was 4, and all 62 patients received a platinum-based doublet as first-line chemotherapy: 57 with carboplatin (92%) and 5 with cisplatin (8%). As best response to the treatment, 19 (31%) partial responses and 20 (32%) stable diseases were observed. Median overall survival was 9.8 months. Toxicity was mild; grade III-IV neutropenia was the most frequently observed side effect in 19 administered cycles (8%). Conclusions: Advanced non-small cell lung cancer in elderly patients can be safely treated with a platinum-based doublet. Observed toxicity is manageable, and overall survival is in keeping with data from the literature.