A large randomized study contradicted that notion in advanced non-small cell lung cancer when data showed that the standard combination chemotherapy, usually given to younger patients, was effective and safe in elderly patients.
When it comes to treating elderly cancer patients with chemotherapy, the prevailing thought has been “less is more” because of potential health risks associated with treatment side effects. And, although most non-small cell lung cancer patients are at least 65 years old and nearly a third are over 70, elderly patients are usually excluded from lung cancer clinical trials and are either not treated at all or treated with a more gentle single chemotherapy agent as opposed to the standard combination that includes a platinum drug.
At ASCO’s plenary session, a large randomized study contradicted that notion in advanced non-small cell lung cancer when data showed that the standard combination chemotherapy, usually given to younger patients, was effective and safe in elderly patients. More than 450 patients aged 70 to 89 were treated with either one chemotherapy drug (vinorelbine or gemcitabine) or a combination of carboplatin and paclitaxel. The overall survival of patients strongly favored the combination (6.2 months versus 10.3 months), with one-year survival improving from 26.9 percent on the single agent to 45.1 percent with the combination. Progression-free survival nearly doubled to 6.1 months.
While the regimen was considered safe, neutropenia, or low white blood cell count, was more common in the combination arm. The study was stopped early when interim results showed a significant benefit with the combination arm. Elisabeth Quoix, MD, professor of medicine at University Hospital in France, predicted that the results will create a paradigm shift in the treatment of elderly lung cancer patients.