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| |  WCLC:Taxane Regimen as Effective and Safe in Elderly Patients with Advanced Non-Small Cell Lung Cancer as in Younger Patients By Patrice Olson VANCOUVER, BC -- August 21, 2003 -- Elderly patients with advanced non-small cell lung cancer (NSCLC) who receive weekly paclitaxel for 3 weeks out of 4 plus monthly carboplatin respond as well as their younger counterparts without experiencing excessive toxicity. Dr. Suresh Ramalingam, assistant professor of medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, and colleagues evaluated three different weekly paclitaxel regimens, all given in combination with carboplatin. The best arm in the overall randomized phase II study was full-dose carboplatin on Day 1 at an area-under-the-curve (AUC) of 6, plus paclitaxel 100 mg/m2 on Days 1, 8 and 15, every 4 weeks. In this arm, median survival was 49 weeks, as Belani et al. reported recently in the Journal of Clinical Oncology (2003 Aug 1;21(15):2933-9.). Dr. Ramalingam and colleagues conducted a sub-analysis of elderly patients involved in the study, to compare outcomes between those aged 70 years and older versus those who were younger than 70 years. He presented their findings during the 10th World Conference on Lung Cancer, held here Aug. 10th-14th. "What we found is that older patients actually tolerate combination therapy very well," Dr. Ramalingam said in an interview. Survival was 49 weeks for patients older than 70 years who received what emerged as the most effective regimen out of the three weekly schedules tested in the study. This compared with a median survival rate of 48 weeks in patients who were less than 70 years. At 1 year, 50% of older patients were still alive, as were 46% of younger patients treated with the same regimen. Two-year survival rates were 23% and 11%, respectively. "There was also no evidence of excessive toxicity for older patients compared with younger patients," the investigators stated. Grade 4 neutropenia occurred in 14% of older patients and 5% of younger patients. The incidence of febrile neutropenia was 2% and 1%, respectively. None of the older patients developed grade 4 thrombocytopenia or grade 3 vomiting, versus 2% and 3% in the younger group, respectively. "The monthly administration of carboplatin plus the weekly administration of paclitaxel for 3 out of 4 weeks seems to be a very friendly regimen in elderly patients and it is associated with good efficacy," Dr. Ramalingam concluded, "and we have not had any problems with patients accepting the weekly regimen either."
[Study title: Elderly Patient Subset Analysis from the Randomized Trial of Three Different Schedules of Weekly Paclitaxel in Combination with Carboplatin for Advanced and Metastatic Non-Small Cell Lung Cancer (NSCLC). Abstract 252]
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