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| |  Patient Age Not a Factor in Use of Second-Line Therapy for Lung Cancer AURORA, Colo -- March 5, 2010 -- Research published in the March issue of the Journal of Thoracic Oncology sought to determine whether differences existed in tolerance and efficacy between patients aged 70 and older and younger patients with non-small cell lung cancer (NSCLC) receiving salvage targeted therapy with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) or chemotherapy. Lung cancer is the leading cause of cancer death in the world. Lung cancer incidence peaks between ages 70 and 80, and the mortality rate increases with age. EGFR-TKIs, such as ge€tinib or erlotinib, are effective agents used in salvage therapy for NSCLC after patients have failed previous chemotherapy and have yielded a modest survival benefit. However, the majority of patients enrolled in these clinical trials using salvage therapy against NSCLC were aged younger than 70 years. Whether elderly patients are as suitable for salvage therapy as younger patients, and whether salvage targeted therapy is better or more tolerable than salvage chemotherapy in elderly patients are both unknown. Chieh-Hung Wu, MD, of Taipei Veterans General Hospital, Taipei, Taiwan, and colleagues retrospectively analysed the data of 461 cases of nonelderly (age, < 70 y) and elderly (age, >= 70 y and older) patients with NSCLC who had failed previous chemotherapy and received salvage therapy. Treatment response rate, time to disease progression, overall survival time and toxicity pro€les of the 2 groups were compared. The nonelderly group had a similar response rate (24%), control rate (68%), and overall survival time (8.3 months) to the elderly group (19%, 68%, 9.3 months, respectively). In fact, the median progression-free time was numerically longer in the elderly than in the nonelderly patients (4.4 months vs 4.1 months). In addition, the use of EGFR-TKI salvage therapy, compared with salvage chemotherapies in the elderly group, resulted in a similar disease control rate and median survival time and more favourable toxicity pro€les. “In our study, we found there were no differences in the efficacy of salvage chemotherapies and EGFR-TKI therapy, in terms of response rate, control rate, and overall survival, in elderly and nonelderly patients, and the therapies had acceptable toxicities,” said Dr. Wu. “Age itself should not preclude patients with NSCLC from second-line salvage therapy with EGFR-TKIs. This is especially important as elderly patients are more easily frustrated when treatment for lung cancer fails and may refuse further salvage therapy.”
SOURCE: International Association for the Study of Lung Cancer
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