Age-Specific Sub-Analysis of ECOG 1594: Fit Elderly Patients (70-80 yrs) with Non-Small Cell Lung Cancer Do As Well As Younger Patients (<70 yrs)
Last Modified: May 31, 2003
Presenter: CJ Langer
Presenter's Affiliation: Fox Chase Cancer Center
Type of Session: Poster
- Exclusion of elderly patients from studies of advanced non-small cell lung cancer (NSCLC) has been common due to fear of increased toxicity of platinum-based regimens in these patients. Previous retrospective studies have been mixed regarding the impact of age on patient outcome and toxicity. ECOG 1594 was previously published and compared four "state-of-the-art" chemotherapy regimens for advance NSCLC. This study retropectively compared the outcomes of elderly (70 yrs or older) patients to younger patients (less than 70 yrs) in ECOG 1594.
- The four arms of the the original study consisted of: 1) cisplatin + paclitaxel q3wks 2)cisplatin + gemcitabine q4wks 3) cisplatin + docetaxel q3wks 4) carboplatin + placlitaxel q3wks.
- A retrospective sub group analysis of patients < 70 yrs versus patients >=70 was performed on the patient population in ECOG 1594.
- 227/1139 eligble patients were >=70 yrs, 9 patients were >=80 yrs
- Demographics were similar for those < 70 yrs and those >=70 yrs.
- There was no difference between the two age groups based for number of patients completing all 6 cycles of chemotherapy, median number of cylces completed, response rate, 1-yr progression-free survival (PFS), 1-yr overall survival (OS), or 2-yr OS
- There was a difference for those < 70 vs. those >=70 for 2-yr PFS (0.5% vs 2.2%, respectively, p=0.04) and for grade 4 or higher toxicity (60% vs. 71.2%, p=0.04) which mainly consisted of myelosuppression
- There was no difference between age groups when analyzed by treatment arms
- Patients >=80 yrs fared worse with 0/9 completing 6 cycles and an overall response rate of 0%.
- Fit elderly patients fared as well as younger patients with similar overall response rates, PFS, and OS.
- Elderly patients did have an increased rate of toxicity, particularly myelosuppression
- Patients >=80 yrs did poorly, although the number of patients was too small to draw broad conclusions for this age group.
- The results of this sub group analysis support the inclusion of fit elderly patients in studies for advanced NSCLC. Although outcome measures were similar for elderly patients, they did experience a higher rate for treatment-related toxicity; therefore, careful pharmacokinetic assessments must be made for elderly patients enrolling in these studies. Patients >=80 yrs need to be studied separately to determine the appropriateness of including these patients in future studies.
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