Evaluation of elderly patients with extended disease small-cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18515-e18515 ◽  
Author(s):  
Tatiane Caldas Montella ◽  
Marina Mendes Vasco ◽  
Ana Licia Maia Silva ◽  
Morgana Stelzer Rossi ◽  
Carla Valéria Santos Sena ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Optimal Care ◽  
Cycle Number ◽  
Dismal Prognosis

e18515 Background: At diagnosis approximately 25-40% of patients with small cell lung cancer (SCLC) are over age 65 and more than 60% of them have extended disease (ED). There is a scarcity of data on this subpopulation. The aim of this study was to report clinical characteristics of this subpopulation, highlighting some challenges in their clinical management. Methods: In this retrospective cohort, data from 96 patients aged >65 years with SCLC diagnosed between 1997 and 2007 at a single institution were analyzed. Results: At diagnosis median age at presentation was 71, and most patients (n=65; 67.7%) had ED_SCLC and became the focus of our analysis. In this particular population the median survival time was 5 compared to 9 months for limited disease patients. Further, 63% of these patients had performance status (PS)≥2 and that was correlated with worse survival (PS0-1=9 months, PS2=4 months and PS3-4=3months; p=0.05). Additionally, 70% of this group with ED had at least one comorbidity and 30% had more than one. Of note, chemotherapy (CT) or radiotherapy (RT) were not administered in 23% of those patients, due to the lack of clinical conditions. CT was administered in 49 patients (75%), being carboplatin and etoposide the preferred regimen in contrast to cisplatin and etoposide (71 vs 28%). However, 44% of patients received less than 4 cycles of CT and 34% received only one cycle. Number of CT cycles were correlated with survival (1 cycle 1.5 months and 2-4cycles 8.7 months). Conclusions: Our data show that elderly patients with ED-SCLC constitutes a frail subpopulation, with poor PS and associated comorbidities, leading to suboptimal treatment and a dismal prognosis. Moreover, most of those patients were considered unfit for current treatment. These results highlight the urgent need for an individualized approach and clinical trials focused on elderly patients, in order to provide them an optimal care and improve their outcomes.

Weekly Vinorelbine in Elderly Patients with Non-Small-Cell Lung Cancer

1994 ◽  
Vol 80 (6) ◽  
pp. 448-452 ◽  
Author(s):  
Marco Colleoni ◽  
Fernando Gaion ◽  
Patrizia Neili ◽  
Gian Mario Colmellere ◽  
Paolo Manente
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Thoracic Pain ◽  
Significant Difference

Aims and background Many lung cancers are diagnosed in patients over 65 years of age, but limited data are available on the tolerance and activity in elderly patients of chemotherapy protocols designed for adults. Methods We therefore activated a phase II study in patients aged 65 years or older affected by stage IIIB-IV non-small-cell lung cancer in order to assess the tolerance and activity of vinorelbine administered weekly at a dose of 25 mg/m2. Results Since June 1992, 25 patients (20 males, 5 females; performance status ECOG, 0-2) have been included in the study and are evaluable for response and side effects. Two-hundred and twenty-eight cycles of therapy have been delivered (median/patient, 9 cycles). Four partial remissions (16%; 95% confidence interval 5–36%), 9 disease stabilizations, and 12 progressions have been observed. Median time to disease progression was 3 months, and median survival was 5 months (range, 2–25+). Mild or moderate side effects included leukopenia (6 cases), neutropenia (4 cases), anemia (4 cases), nausea (4 cases), infection (3 cases) and thoracic pain (2 cases). Grade III/IV toxicity consisted mainly of leukopenia and neutropenia observed respectively in 5 and in 7 patients. No significant difference in terms of tolerability has been observed for patients aged 65 to 70 with respect to patients aged 70 years or older. Conclusions The administration of vinorelbine in elderly patients does not seem to differ significantly in terms of response and tolerability from that recorded for adults. Selected elderly patients with good performance status and adequate organ function can be safely treated with systemic chemotherapy.

A Phase II Study of S-1 for Previously Untreated Elderly Patients with Advanced Non-Small Cell Lung Cancer

Chemotherapy ◽  
2015 ◽  
Vol 61 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Takashi Kasai ◽  
Yoichi Nakamura ◽  
Minoru Fukuda ◽  
Takeshi Kitazaki ◽  
Seiji Nagashima ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Response Rate ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Eligibility Criteria ◽  
Grade 3

Background: S-1, a novel oral fluoropyrimidine, is active in the treatment of non-small cell lung cancer (NSCLC). However, data on S-1 for elderly patients with NSCLC are insufficient. Methods: Eligibility criteria were no prior chemotherapy, stage IIIB or IV NSCLC, performance status 0-1, age >70 years, and adequate hematological, hepatic, and renal functions. Patients received S-1 (40 mg/m2 twice a day) for 28 consecutive days. This schedule was repeated every 6 weeks. The primary end point was the tumor response rate. Results: Thirty-two patients were enrolled and 31 patients were evaluable for response. The patients' median age was 80 years (range: 71-88). The response rate was 22.6% (95% CI: 11-38). Neutropenia, anemia, thrombocytopenia, febrile neutropenia, and diarrhea of grade ≥3 occurred in 6, 6, 10, 3, and 3%, respectively. Conclusions: In elderly patients with previously untreated advanced NSCLC, S-1 appears to be well tolerated and demonstrates encouraging activity.

scholarly journals Do Elderly Lung Cancer Patients Aged ≥75 Years Benefit from Immune Checkpoint Inhibitors?

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1995
Author(s):  
Nagio Takigawa ◽  
Nobuaki Ochi ◽  
Nozomu Nakagawa ◽  
Yasunari Nagasaki ◽  
Masataka Taoka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Lung Cancer Patients

Lung cancer patients ≥75 years represent nearly 40% of all lung cancer patients and continue to increase. If elderly patients have a good performance status and adequate organ function, they can be treated the same as non-elderly patients. However, few comparative studies limited to elderly patients (≥75 years) have been conducted. We review the evidence on using immune check inhibitors for the treatment of elderly patients (≥75 years old) with advanced non-small cell lung cancer. Prospective randomized or non-randomized, retrospective, registrational, insurance-based, and community-based studies have shown that elderly (≥75 years) and non-elderly patients are similarly treated with immune check inhibitors effectively and safely. However, such analyses have not shown that immune check inhibitors are significantly more effective than chemotherapy alone. In addition, patient selection might be critically performed to administer immune check inhibitors in the elderly because they are more likely to have a poor performance status with comorbidities, which lead to little benefit, even in non-elderly patients. There is a need for more evidence showing the benefit of immune check inhibitors in non-small cell lung cancer patients ≥75 years.

Docetaxel compared with vinorelbine in elderly patients with advanced non-small cell lung cancer (NSCLC): A randomized phase II Hellenic Oncology Research Group trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7615-7615 ◽  
Author(s):  
A. Karampeazis ◽  
L. Vamvakas ◽  
A. Agelidou ◽  
V. Chandrinos ◽  
X. Tsiafaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Statistical Difference ◽  
Median Overall Survival ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung

7615 Background: To compare docetaxel versus vinorelbine as front-line treatment of elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Chemotherapy-naive patients >65 years, with stage histologically or cytologically documented IIIB/IV NSCLC and performance status (PS) 0–3 were randomly assigned to receive docetaxel 38 mg/m2 (days 1 and 8) or vinorelbine 25 mg/m2 (days 1 and 8) every 21 days. Treatment was continued for a maximum of six cycles and was interrupted in case of disease progression or unacceptable toxicity. Results: A total of 112 patients with median age of 76 years (range, 66–87) were enrolled onto the study. PS 2–3 had 39 (35%) patients. The two treatment groups were well balanced. There was no statistical difference between the 2 arms in median overall survival (6.27 months vs 3.97 months; p=0.129), in median time to progression (2.2 months vs 2 months; p=0.863.) and in overall response rate (5.3% vs 11.3%; p=0.247). Docetaxel conferred a statistically significant survival benefit compared to vinorelbine only in patients with PS 0–1 (11.4 months vs 4.3 months; p=0.009). Among patients treated with docetaxel there was a significant difference in median overall survival for patients with PS 0–1 compared with patients with PS 2–3 (11.4 months vs 2.5 months; p=0.004) while there was no statistical difference in the vinorelbine arm (4.3 months vs 2.8 months; p=0.970).The most common grade 3 and 4 toxicity was neutropenia (3.4% for docetaxel; 27.8% for vinorelbine; p=0.0001). Other toxicities were mild, well tolerated and similar for both groups with the exception of asthenia grade 2 (8.6% for docetaxel; 24.1% for vinorelbine; p=0.026). Conclusions: Docetaxel improves survival compared with vinorelbine in elderly patients with advanced non-small-cell lung cancer and good performance status without increasing toxicity. No significant financial relationships to disclose.

scholarly journals Phase I-II Trial of Gemcitabine-Based First-Line Chemotherapies for Small Cell Lung Cancer in Elderly Patients with Performance Status 0-2: The G-Step Trial

2012 ◽  
Vol 7 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Cesare Gridelli ◽  
Ciro Gallo ◽  
Alessandro Morabito ◽  
Rosario Vincenzo Iaffaioli ◽  
Adolfo Favaretto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Phase I ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Step Trial

Combination chemotherapy with irinotecan and cisplatin in elderly patients (≥65 years) with extensive-disease small-cell lung cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18135-18135
Author(s):  
G. Lee ◽  
K. Kim ◽  
Y. Cho ◽  
H. Kim ◽  
I. Hwang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combination Chemotherapy ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Ecog Performance Status ◽  
Grade 3

18135 Background: Combination chemotherapy with irinotecan and cisplatin is one of the standard treatments for patients with small-cell lung cancer (SCLC). In elderly patients, however, its efficacy and toxicity has not been well documented. In this Phase II study, we assessed the efficacy and toxicity of combination chemotherapy with irinotecan and cisplatin and examined whether advanced age compromises it in elderly patients with previously untreated extensive-disease small-cell lung cancer (ED-SCLC). Methods: In this study, 43 previously untreated elderly patients (65 years or older) with ED-SCLC were given combination chemotherapy consisting of irinotecan 60mg/m2 on days 1, 8 and 15 and cisplatin 60mg/m2 on days 1. The treatment was repeated every four weeks until patients completed the maximum six cycles. Results: Patients consisted of 34 men and 9 women, whose median age was 70 years (range 65 - 81 years). A complete response and a partial response were observed in 23.3% (10/43) and 58.1% (25/43), respectively. The overall response rate was 81.4% (95% C.I; 69.7 - 93.0%). The overall median survival was 10.3 months (range 7.8 - 12.7 months). The 1-year and 2- year survival rates were 31.8% and 3.4%, respectively. The median progression-free survival was 8.32 months (range 6.8 - 9.8 months). Major toxicities included neutropenia (grade 3 to 4, 55.9%), leukopenia (grade 3 to 4, 46.5%), infection (grade 3 to 4, 37.3%) and diarrhea (grade 3 to 4, 30.3%). Incidence of febrile neutropenia was significantly higher in patients with ECOG performance status 2 compared with ECOG performance 1 (70.7% vs. 5.2%; p < 0.001). There were two treatment related deaths in patients ECOG performance status 2. Conclusions: Our results indicate that combination chemotherapy with irinotecan and cisplatin is an effective treatment for elderly patients with ED-SCLC. However, physicians should be aware of the mortality and morbidity due to myelosuppression following this treatment in elderly ED-SCLC patients with ECOG performance status 2. No significant financial relationships to disclose.

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