Toshio Kato1, Masahiro Morise2, Masahiko Ando3, Eiji Kojima4, Tomohiko Ogasawara5, Ryujiro Suzuki6, Joe Shindoh7, Masami Matsumoto8, Yasuteru Sugino9, Masahiro Ogawa10, Yasuhiro Nozaki11, Tetsunari Hase1, Masashi Kondo1, Hiroshi Saito12, Yoshinori Hasegawa1. 1. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. 2. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. morisem@med.nagoya-u.ac.jp. 3. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan. 4. Department of Respiratory Medicine, Komaki Municipal Hospital, Komaki, Japan. 5. Department of Respiratory Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan. 6. Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan. 7. Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan. 8. Department of Respiratory Medicine, Ichinomiya Municipal Hospital, Ichinomiya, Japan. 9. Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Japan. 10. Department of Respiratory Medicine, Handa City Hospital, Handa, Japan. 11. Department of Respiratory Medicine, Chukyo Hospital, Nagoya, Japan. 12. Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
Abstract
PURPOSE: Predicting the feasibility of platinum-based chemotherapy remains an important issue in elderly (over 70 years) patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify the risk factors for the early serious adverse events (SAEs) (during cycles 1-2) in elderly receiving platinum-based chemotherapy, and to explore the clinical characteristics of patients who require early treatment termination without progressive disease (PD). METHODS: One hundred and ninety-eight consecutive elderly NSCLC patients receiving platinum-based chemotherapy were retrospectively reviewed. RESULTS: The median age was 73 years (range 70-83). 161 (81 %) were males, and 190 (95 %) were PS 0-1. Fifty-one (29 %) and 39 (19 %) patients developed early non-hematological SAEs and hematological SAEs, respectively. Multivariate analysis identified low serum albumin (<3.0 g/dl) as an independent risk factor for non-hematological SAEs, while low creatinine clearance (<45 ml/min) for hematological SAEs. In all, 24 (12 %) patients needed early treatment termination without PD. The major reason for this event was the development of non-hematological SAEs (4.5 %), followed by grade 2 non-hematological adverse events (AEs) (3 %). In multivariate analysis, age over 75 years and low serum albumin were associated with this event. The median overall survival (OS) in patients with this event was only 6.0 months, while the development of early SAE was not associated with poor OS. CONCLUSION: Baseline serum albumin might be useful for predicting the feasibility of platinum-based chemotherapy, and the risk estimation of early treatment termination without PD might be beneficial for the treatment selection in elderly NSCLC patients.
PURPOSE: Predicting the feasibility of platinum-based chemotherapy remains an important issue in elderly (over 70 years) patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify the risk factors for the early serious adverse events (SAEs) (during cycles 1-2) in elderly receiving platinum-based chemotherapy, and to explore the clinical characteristics of patients who require early treatment termination without progressive disease (PD). METHODS: One hundred and ninety-eight consecutive elderly NSCLCpatients receiving platinum-based chemotherapy were retrospectively reviewed. RESULTS: The median age was 73 years (range 70-83). 161 (81 %) were males, and 190 (95 %) were PS 0-1. Fifty-one (29 %) and 39 (19 %) patients developed early non-hematological SAEs and hematological SAEs, respectively. Multivariate analysis identified low serum albumin (<3.0 g/dl) as an independent risk factor for non-hematological SAEs, while low creatinine clearance (<45 ml/min) for hematological SAEs. In all, 24 (12 %) patients needed early treatment termination without PD. The major reason for this event was the development of non-hematological SAEs (4.5 %), followed by grade 2 non-hematological adverse events (AEs) (3 %). In multivariate analysis, age over 75 years and low serum albumin were associated with this event. The median overall survival (OS) in patients with this event was only 6.0 months, while the development of early SAE was not associated with poor OS. CONCLUSION: Baseline serum albumin might be useful for predicting the feasibility of platinum-based chemotherapy, and the risk estimation of early treatment termination without PD might be beneficial for the treatment selection in elderly NSCLCpatients.
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: I Gioulbasanis; V E Baracos; Z Giannousi; A Xyrafas; L Martin; V Georgoulias; D Mavroudis Journal: Ann Oncol Date: 2010-10-11 Impact factor: 32.976
Authors: Maria De Santis; Joaquim Bellmunt; Graham Mead; J Martijn Kerst; Michael Leahy; Pablo Maroto; Iwona Skoneczna; Sandrine Marreaud; Ronald de Wit; Richard Sylvester Journal: J Clin Oncol Date: 2009-09-28 Impact factor: 44.544