Pemetrexed therapy in elderly patients with good performance status: analysis of two phase III trials of patients with nonsquamous non-small-cell lung cancer
| Autor: | Corey J. Langer, Patrick Peterson, Mominul Islam, Susan C. Guba, Giorgio V. Scagliotti, Patti Moore, Carla Visseren-Grul, Cesare Gridelli, Thomas Brodowicz |
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| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology Male Cancer Research medicine.medical_specialty Guanine Lung Neoplasms medicine.medical_treatment Pemetrexed Maintenance therapy Glutamates Internal medicine Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols medicine Humans Lung cancer Survival rate Aged Neoplasm Staging Retrospective Studies Chemotherapy Performance status business.industry Middle Aged medicine.disease Prognosis Gemcitabine Clinical trial Survival Rate Female Cisplatin business medicine.drug |
| Zdroj: | Clinical lung cancer. 13(5) |
| ISSN: | 1938-0690 |
| Popis: | A widely held misperception contends that all elderly patients, even those with good performance status (PS 0-1), are unable to tolerate aggressive chemotherapy. The objective of these analyses was to evaluate the survival and safety of treatment with pemetrexed in elderly patients with nonsquamous non-small-cell lung cancer (NSCLC) and PS 0-1.Two randomized studies, 1 reporting the activity of pemetrexed in combination with cisplatin vs. cisplatin and gemcitabine in chemotherapy-naive patients (N = 1725) and another comparing single-agent pemetrexed with placebo in the maintenance setting (N = 663) were retrospectively considered. Data from patients with nonsquamous advanced NSCLC with PS 0-1 in these studies were evaluated in 2 separate dichotomous analyses (65 years and ≥ 65 years and70 years and ≥ 70). Cox proportional hazard models were used to estimate covariate-adjusted between-arm hazard ratios (HRs) with 95% confidence intervals for each age group.In the first-line study, 32.7% of the 1252 patients with nonsquamous NSCLC were ≥ 65 years and 12.8% were ≥ 70 years old. In the maintenance study, 33.1% of the 481 patients with nonsquamous NSCLC were ≥ 65 years and 16.0% were ≥ 70 years old. In both studies, the adjusted HRs for overall survival (range, 0.62-0.89) favored pemetrexed and were similar between the older and younger age groups. Dose intensity delivered and toxicities observed for patients treated with pemetrexed were manageable and similar between the older and younger age groups.For elderly patients with nonsquamous advanced NSCLC and PS 0-1, pemetrexed therapy, with its favorable toxicity profile, is a viable option, either in combination with cisplatin in the first-line setting or as maintenance therapy after initial chemotherapy. |
| Databáze: | OpenAIRE |
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