Should elderly non-small-cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the North Central Cancer Treatment Group.

Abstract

PURPOSE:

To answer the question, "should elderly non-small-cell lung cancer patients be offered elderly-specific trials?"

PATIENTS AND METHODS:

The North Central Cancer Treatment Group (NCCTG) performed a pooled analysis of elderly patients who participated in elderly-specific trials (required age > or = 65 years) and age-unspecified trials (required age > or = 18 years). Between 1998 and 2000, all NCCTG non-small-cell lung cancer (NSCLC) patients with incurable cancer, age > or = 65 years, and receiving first-line chemotherapy were included. A total of 118 elderly patients participated in elderly-specific trials, and 108, in age-unspecified trials. Demographics and outcomes were compared based on trial type.

RESULTS:

The median age of elderly patients in elderly-specific trials was greater: median (range): 73 years (65 to 87) and 70 years (65 to 85), respectively (P < .001), as was the percentage older than 80 years: 17% and 3%, respectively (P = .0008). Median survival times were 232 and 302 days, respectively (P = .08). After adjustment for baseline age, Eastern Cooperative Oncology Group performance score, cancer stage, and body mass index, this survival difference was not statistically significant (hazard ratio = 1.25; P = .16). Grade 3 or worse nonhematologic adverse event rates were greater in age-unspecified trials (81% v 57%, respectively; P < .001), as were grade 3 or worse hematologic events (68% v 10%, respectively; P < .001).

CONCLUSION:

Elderly patients in NSCLC elderly-specific trials suffered lower rates of severe adverse events with no statistically significant differences in survival. It seems that elderly-specific trials are providing quality care and helping to define optimal cancer therapy in the elderly, particularly among the "oldest of the old."

• Authors: Aminah Jatoi, Shauna Hillman, Philip Stella, Erin Green, Alex Adjei, Suresh Nair, Edith Perez, Bipinkur Amin, Steven E Schild, Rene Castillo, James R Jett, North Central Cancer Treatment Group
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 23 Issue 36 Pg. 9113-9 (Dec 20 2005) ISSN: 0732-183X [Print] United States
• PMID: 16361618 (Publication Type: Journal Article)

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Aging
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• Female
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Male
• Prognosis
• Retrospective Studies
• Survival Analysis