Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer

• Published in: Tumori 2013-11, Vol.99 (6), p.650-655
• Main Authors: Piacentini, Paolo, Greco, Filippo, Mercanti, Anna, Trolese, Anna Rita, Durante, Emilia, Moratello, Giacomo, Tognetto, Michele, Furini, Lara, Giuliani, Jacopo, Bonetti, Andrea
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Squamous Cell - drug therapy; Cisplatin - administration & dosage; Comorbidity; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Drug Administration Schedule; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Male; Neoplasm Staging; Retrospective Studies; Treatment Outcome; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives
• ISSN: 0300-8916; 2038-2529
• DOI: 10.1177/030089161309900602

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.