Details

Autor(en) / Beteiligte

• Hennessy, B.T.
• Hanrahan, E.O.
• Breathnach, O.S.

Titel

Chemotherapy Options for the Elderly Patient with Advanced Non‐Small Cell Lung Cancer

Ist Teil von

• The oncologist (Dayton, Ohio), 2003-01, Vol.8 (3), p.270-277

Ort / Verlag

Durham, NC, USA: AlphaMed Press

Erscheinungsjahr

2003

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Learning Objectives After completing this course, the reader will be able to: Describe the available clinical trial data of chemotherapy for advanced non‐small cell lung cancer in elderly patients. Compare older chemotherapy combinations with newer single agents in the treatment of advanced non‐small cell lung cancer. Identify reasons why elderly patients with lung cancer have been excluded from clinical trials. Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com Combination chemotherapy has been shown to improve overall survival compared with best supportive care in patients with advanced non‐small cell lung cancer (NSCLC). The survival advantage is modest and was initially demonstrated with cisplatin‐containing regimens in a large meta‐analysis of randomized trials reported in 1995. Newer chemotherapy combinations have been shown to be better tolerated than older cisplatin‐based combinations, and some trials have also shown greater efficacy and survival benefits with these newer combinations. Combination chemotherapy is, therefore, the currently accepted standard of care for patients with good performance statuses aged less than 70 years with advanced NSCLC. However, there are limited data from clinical trials to support the use of combination chemotherapy in elderly patients over 70 years of age with advanced NSCLC. Subgroup analyses of large randomized phase III trials suggest that elderly patients with good performance statuses do as well as younger patients treated with combination chemotherapy. There are few randomized trials reported that evaluate chemotherapy in patients aged greater than 70 years only. Based on data from trials performed by an Italian group, single‐agent vinorelbine has been shown to have significant activity in elderly patients with advanced NSCLC and to be well tolerated by those patients with Eastern Cooperative Oncology Group performance statuses of two or less, with associated improvements in measures of global health.