Comparison of single-agent chemotherapy and targeted therapy to first-line treatment in patients aged 80 years and older with advanced non-small-cell lung cancer
Authors Zhang Q, Wang Z, Guo J, Liu L, Han X, Li M, Fang S, Bi X, Tang N, Liu Y
Received 29 January 2015
Accepted for publication 11 March 2015
Published 20 April 2015 Volume 2015:8 Pages 893—898
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Daniele Santini
Qianqian Zhang,1 Zhehai Wang,2 Jun Guo,2 Liyan Liu,2 Xiao Han,2 Minmin Li,1 Shu Fang,1 Xiang Bi,1 Ning Tang,1 Yang Liu1
1School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, 2Department of Oncology, Shandong Cancer Hospital, Jinan, People’s Republic of China
Purpose: The aim of this study was to compare single-agent chemotherapy with targeted therapy in initial treatment and to explore a better choice of treatment for patients aged 80 years and older with advanced non-small-cell lung cancer (NSCLC).
Patients and methods: A retrospective chart review was conducted for 136 patients aged 80 years and older who were cytopathologically diagnosed and staged as advanced (stage IIIB or IV) NSCLC. The patient population was divided into two treatment groups: 78 patients were allocated to the chemotherapy group (group A, pemetrexed or gemcitabine or docetaxel as a single agent), and 60 patients were allocated to another group and received epidermal growth factor-receptor tyrosine-kinase inhibitors (group B, erlotinib or gefitinib as a single agent). The primary end points were overall survival (OS) and progression-free survival (PFS), and the secondary end points were response rate, disease-control rate, safety, and quality of life.
Results: In group A and group B, respectively, the median PFS was 2 versus 4 months (P=0.013), and the median OS was 8 versus 16 months (P=0.025). The 1- and 2-year survival rates of the two groups were 23.7% (group A, 18 of 76) versus 76.7% (group B, 46 of 60) and 13.2% (group A, ten of 76) versus 10% (group B, six of 60), respectively. The response rate and disease-control rate were 28.9% versus 36.7% (P=0.39) and 57.9% versus 76.7% (P=0.022) in group A and group B, respectively.
Conclusion: Elders aged 80 years and over with advanced NSCLC in group B had longer PFS and OS compared with group A. It was well tolerated in group B because of the mild adverse effects. Targeted therapy can be considered primarily for patients aged 80 years and older with advanced NSCLC who cannot tolerate chemotherapy or radiotherapy.
Keywords: non-small-cell lung cancer, elderly, 80 years old, first-line, chemotherapy, targeted therapy
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]