Age should not be a barrier to cisplatin-based therapy for lung cancer

NEW YORK (Reuters Health) – Among fit elderly patients undergoing aggressive platinum-based therapy for non-small-cell lung cancer, the response rates, toxicity levels, and survival rates are similar to those seen among fit younger patients, researchers report in the February 6th issue of the Journal of the National Cancer Institute.

In an interview with Reuters Health, lead author Dr. Corey J. Langer, from the Fox Chase Cancer Center, Philadelphia, said "there is a perception that the elderly are not up to receiving systemic therapy for advanced lung cancer, either because they are unfit, or because resources should not be spent on this population. This is a stigma that is applied to lung cancer in general and amplified in the elderly with lung cancer," he added.

Dr. Langer and colleagues retrospectively analyzed data from the Eastern Cooperative Oncology Group 5592, phase III trial. This trial compared cisplatin plus etoposide with cisplatin plus paclitaxel in patients with non-small-cell lung cancer who were chemotherapy-naןve. Dr. Langer's group looked at outcomes based on patient age.

Although elderly patients had more myelosuppression and neuropsychiatric toxicity than younger patients did, the rate of other toxicities in the two groups was identical, Dr. Langer said. "There were no major differences in response rate, time to progression, and median survival," he noted.

Among the 574 patients in the trial, 86 were 70 years of age or older. The proportion of patients under the age of 70 with a partial or complete response to therapy was 22% compared to 23% among patients who were 70 or older. Median time to progression was 4.30 months among elderly patients versus 4.37 months among younger patients.

Median survival was also similar in patients 70 years of age or older and those under 70 years of age, at 8.53 months versus 9.05 months, respectively.

"Age should not be the sole determinate to receiving treatment," Dr. Langer said. "The fit elderly do as well or as poorly as the fit young. As I like to say: performance status trumps age."

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