Clinical benefit of platinum doublet combination therapy in older adults with advanced non‐small cell lung cancer: A prospective multicenter study by the National Hospital Organization in Japan

Autor: Mototsugu Shimokawa, Masaki Kanazu, Ryusei Saito, Masahide Mori, Atsuhisa Tamura, Yoshio Okano, Yuka Fujita, Takeo Endo, Mitsuru Motegi, Shohei Takata, Toshiyuki Kita, Noriaki Sukoh, Fumitaka Mizuki, Mitsuhiro Takenoyama, Shinji Atagi
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Thoracic Cancer, Vol 14, Iss 17, Pp 1597-1605 (2023)
Druh dokumentu: article
ISSN: 1759-7714
1759-7706
DOI: 10.1111/1759-7714.14904
Popis: Abstract Background Previous trials suggest that older adults with non‐small cell lung cancer (NSCLC) derive benefit from platinum doublet combination therapy, but its superiority is controversial. Although geriatric assessment variables are used to assess the individual risk of severe toxicity and clinical outcomes in older patients, the standard first‐line treatment is still debated. Therefore, we aimed to identify the risk factors for clinical outcomes in older patients with NSCLC. Methods Patients aged ≥75 years with advanced NSCLC treated at any of 24 National Hospital Organization institutions completed a pre‐first‐line chemotherapy assessment, including patient characteristics, treatment variables, laboratory test values, and geriatric assessment variables. We evaluated whether these variables were the risk factors for progression‐free survival (PFS) and overall survival (OS). Results A total of 148 patients with advanced NSCLC were treated with combination therapy (n = 90) or monotherapy (n = 58). Median PFS was 5.3 months and OS was 13.6 months. We identified that hypoalbuminemia (hazard ratio [HR] 2.570, 95% confidence interval [CI]: 1.117–5.913, p = 0.0264) was a risk factor for PFS and monotherapy (HR 1.590, 95% CI: 1.070–2.361, p = 0.0217), lactate dehydrogenase (HR 3.682, 95% CI: 1.013–13.39, p = 0.0478), and high C‐reactive protein (HR 2.038, 95% CI: 1.141–3.642, p = 0.0161) were risk factors for OS. The median OS was significantly longer in patients treated with combination therapy than in those who received monotherapy (16.5 months vs. 10.3 months; HR 0.684, 95% CI: 0.470–0.995, p = 0.0453). Discussion Platinum doublet combination therapy may be beneficial in older patients with NSCLC. Identification of risk factors will assist in the development of a personalized treatment strategy.
Databáze: Directory of Open Access Journals
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