Online citations, reference lists, and bibliographies.
← Back to Search

Elderly Patients Benefit From Second-line Cytotoxic Chemotherapy: A Subset Analysis Of A Randomized Phase III Trial Of Pemetrexed Compared With Docetaxel In Patients With Previously Treated Advanced Non-small-cell Lung Cancer.

G. Weiss, C. Langer, R. Rosell, N. Hanna, F. Shepherd, L. Einhorn, B. Nguyen, S. Paul, P. McAndrews, P. Bunn, K. Kelly
Published 2006 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
PURPOSE Numerous prospective and retrospective studies have concluded that elderly patients (> or = 70 years old) achieve a similar survival benefit, with acceptable toxicity, from first-line cytotoxic chemotherapy for the treatment of advanced non-small-cell lung cancer (NSCLC) compared with their younger counterparts. However, few published data exist on the efficacy and tolerability of second-line cytotoxic therapy in this population. PATIENTS AND METHODS Retrospective analysis of a large second-line trial was performed. Data from 571 patients randomly assigned to docetaxel 75 mg/m2 or pemetrexed 500 mg/m2 every 3 weeks were analyzed for efficacy and toxicity comparisons between age groups and treatment arms. RESULTS Eighty-six of 571 patients (15%) were > or = 70 years old, similar to rates of elderly observed in the first-line setting. Elderly patients receiving pemetrexed (n = 47) or docetaxel (n = 39) had a median survival of 9.5 and 7.7 months compared with 7.8 and 8.0 months for younger patients receiving pemetrexed (n = 236) or docetaxel (n = 249), respectively. Elderly patients treated with pemetrexed had a longer time to progression and a longer survival than their counterpart patients treated with docetaxel (not statistically significant). Febrile neutropenia was less frequent in elderly patients treated with pemetrexed (2.5%) compared with docetaxel (19%; P = .025), with only one death as a result of toxicity (docetaxel arm). CONCLUSION Elderly patient participation was similar to rates observed in the first-line setting. There was no significant difference in outcome or toxicity between elderly and younger patients. For elderly patients with advanced NSCLC and good performance status, second-line cytotoxic therapy is appropriate. In this subset, pemetrexed produced a more favorable toxicity profile.
This paper references
Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian Lung Cancer in the Elderly Study (MILES) phase III randomized trial.
C. Gridelli (2003)
Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy.
F. Shepherd (2000)
Single-agent versus combination chemotherapy in advanced non-small-cell lung cancer: the cancer and leukemia group B (study 9730).
R. Lilenbaum (2005)
The impact of age on toxicity, response rate, quality of life, and survival in patients with advanced, Stage IIIB or IV nonsmall cell lung carcinoma treated with carboplatin and paclitaxel
T. Hensing (2003)
O-51 Phase III study (TAX 326) of docetaxel-cisplatin (DC) and docetaxel-carboplatin (DCB) versus vinorelbine-cisplatin (VC) for the first-line treatment of advanced/metastatic non-small cell lung cancer (NSCLC): analyses in elderly patients
C. Belani (2003)
Chemotherapy in patients ≥ 80 with advanced non-small cell lung cancer: combined results from SWOG 0027 and LUN 6
P. Hesketh (2005)
Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy.
N. Hanna (2004)
Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.
P. Maione (2005)
Mantle cell lymphoma: at last, some hope for successful innovative treatment strategies.
R. Fisher (2005)
American Society of Clinical Oncology treatment of unresectable non-small-cell lung cancer guideline: update 2003.
D. Pfister (2004)
Outcome of elderly (≥70 years) non-small cell lung cancer (NSCLC) patients on a multicenter, phase III randomized trial comparing weekly vs. standard schedules of paclitaxel (P) plus carboplatin (C)
S. Ramalingam (2005)
Prospective evaluation of the pharmacokinetics and toxicity profile of docetaxel in the elderly.
A. T. Ten Tije (2005)
Erlotinib in previously treated non-small-cell lung cancer.
F. Shepherd (2005)
The ELVIS trial: a phase III study of single-agent vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer. Elderly Lung Cancer Vinorelbine Italian Study.
C. Gridelli (2001)
O-49 Age-specific subanalysis of ECOG 1594: Fit elderly patietns (70–80 yrs) with NSCLC do as well as younger patients (<70)
C. Langer (2003)
Randomized Phase III Trial of Docetaxel Versus Vinorelbine or Ifosfamide in Patients With Advanced Non–Small-Cell Lung Cancer Previously Treated With Platinum-Containing Chemotherapy Regimens
F. Fossella (2000)
Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial.
C. Langer (2002)
Lawrence M Leemis (1993)

This paper is referenced by
Real-world effectiveness of systemic agents approved for advanced non-small cell lung cancer: a SEER-Medicare analysis.
T. K. Owonikoko (2013)
Traitements de rattrapage du cancer bronchique non à petites cellules
Gavin Plat (2011)
[American Society of Clinical Oncology Clinical Practice Guideline update on chemotherapy for stage IV non-small-cell lung cancer].
C. Azzoli (2010)
Non-small cell lung cancer therapy in the elderly.
C. Gridelli (2011)
[Prognostic factors in 408 elderly lung cancer patients more than 70 years old].
Hua Zheng (2011)
American Society of Clinical Oncology Clinical Practice Guideline update on chemotherapy for stage IV non-small-cell lung cancer.
C. Azzoli (2009)
Clinical Outcomes and Biomarker Profiles of Elderly Pretreated NSCLC Patients from the BATTLE Trial
A. Tsao (2012)
Lung cancer survival in Spain and prognostic factors: a prospective, multiregional study.
Julio Sánchez de Cos (2008)
Metastatic non-small cell lung cancer Current treatment based on evidence* (ONCOLGroup)
Carlos Castro (2010)
Efficacy and treatment tolerance in older patients with NSCLC: a meta-analysis of five phase III randomized trials conducted by the Hellenic Oncology Research Group.
A. Pallis (2011)
Current treatment based on evidence * (ONCOLGroup)
Carlos Castro (2010)
Pemetrexed: potential role in the adjuvant chemotherapy of non-small cell lung cancer.
M. Vincent (2010)
Real‐world chemotherapy treatment patterns in metastatic non–small cell lung cancer: Are patients undertreated?
A. Sacher (2015)
The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer.
G. Weiss (2007)
Critical appraisal of pemetrexed in the treatment of NSCLC and metastatic pulmonary nodules
X. Li (2014)
Pemetrexed therapy in elderly patients with good performance status: analysis of two phase III trials of patients with nonsquamous non-small-cell lung cancer.
C. Gridelli (2012)
quels patients âgés ? Cancers bronchopulmonaires non à petites cellules Non-small-cell lung cancer
L. Belmont (2008)
Update on nonsmall cell lung cancer
G. Zalcman (2010)
Challenges treating older non-small cell lung cancer patients.
C. Gridelli (2008)
Treatment of Advanced Lung Cancer
S. Ou (2009)
Pemetrexed Followed by Docetaxel or a Reverse Sequence in Non-Small-Cell Lung Cancer
Wen-Chien Fan (2009)
Chemotherapy for the Older Adult with Cancer
S. Mohile (2009)
Real-world cost-effectiveness analysis of second-line pemetrexed versus docetaxel in the Ontario nonsmall- cell lung cancer population
Dolly Han (2015)
Second-line chemotherapy for non-small cell lung cancer
F. Marinis (2006)
International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients--an analysis of the medical literature.
S. Lichtman (2007)
Randomized phase II study of pemetrexed or pemetrexed plus bevacizumab for elderly patients with previously untreated non-squamous non-small cell lung cancer: Results of the Lung Oncology Group in Kyushu (LOGIK1201).
M. Fukuda (2019)
Targeted delivery of monoclonal antibody conjugated docetaxel loaded PLGA nanoparticles into EGFR overexpressed lung tumour cells
Jitendrakumar D. Patel (2018)
Chapter 13 – Chemotherapy-Induced Myelosuppression in the Elderly
Bindu Kanapuru (2012)
Improving patient management in metastatic non-small cell lung cancer.
J. Vansteenkiste (2007)
Systemic Therapy of Common Tumours in Older Patients: Challenges and Opportunities. A Young International Society of Geriatric Oncology Review Paper
N. Battisti (2020)
Gemcitabine Plus Vinorelbine as the Second-Line Treatment and Beyond in Elderly Patients with Platinum-Pretreated Advanced Non-Small Cell Lung Cancer
S. Go (2014)
Pemetrexed for the treatment of non-small-cell lung cancer
C. Manegold (2009)
See more
Semantic Scholar Logo Some data provided by SemanticScholar