Among patients age 70 or older with advanced non-small cell lung cancer (NSCLC), treatment with a combination of two chemotherapy drugs—paclitaxel and carboplatin—results in better progression-free and overall survival than treatment with single-agent chemotherapy. The results of this Phase III clinical trial will be presented at the 2010 annual meeting of the American Society of Clinical Oncology.
Lung cancer remains the leading cause of cancer death in the United States. Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers.
At least 30% of NSCLC cases occur in people age 70 or older, but there is limited information about how best to treat older patients. As a result of the limited information and concern that elderly patients will not be able to tolerate aggressive treatment, older patients may be treated with single-agent chemotherapy rather than combination chemotherapy.
To explore treatment options for older patients with advanced NSCLC, researchers in France conducted a Phase III clinical trial in 451 patients between the ages of 70 and 89. Patients were assigned to receive either combination chemotherapy with paclitaxel and carboplatin, or single-agent chemotherapy with gemcitabine or vinorelbine.
- Overall survival was 10.4 months among patients treated with combination chemotherapy and 6.2 months among patients treated with single-agent chemotherapy.
- Survival without cancer progression was 6.3 months among patients treated with combination chemotherapy and 3.2 months among patients treated with single-agent chemotherapy.
- Combination chemotherapy had acceptable toxicity, but did increase the likelihood of moderate to severe neutropenia (low white blood cell counts).
These results suggest that older patients with advanced NSCLC can be considered for the same aggressive therapy as younger patients.
Reference: Quoix EA, Oster J, Westeel V et al. Weekly paclitaxel combined with monthly carboplatin versus single agent therapy in patients aged 70 to 89: IFCT-0501 randomized phase III study in advanced non-small cell lung cancer (NSCLC). Presented at the 2010 annual meeting of the American Society of Clinical Oncology. June 4-8, 2010. Chicago, IL. Abstract 2.