Cancer Treatment Reviews
Volume 36, Issue 5 , Pages 436-441 , August 2010

Is age a negative prognostic factor for the treatment of advanced/metastatic non-small-cell lung cancer?

  • A.G. Pallis

      Affiliations

    • EORTC-Elderly Task Force Member and Department of Medical Oncology, University General Hospital of Heraklion, Greece
    • Corresponding Author InformationCorresponding author. Address: Department of Medical Oncology, University General Hospital of Heraklion, P.O. Box 1352, Heraklion 71110, Crete, Greece. Tel.: +32 (0) 2 774 10 62.
  • ,
  • C. Gridelli

      Affiliations

    • Division of Medical Oncology, “S.G. Moscati” Hospital, Avellino, Italy

Received 2 December 2009 ,Accepted 26 December 2009.

References 

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer Statistics, 2009. CA Cancer J Clin 2009;59(4):225–49.
  2. Gridelli C, Perrone F, Monfardini S. Lung cancer in the elderly. Eur J Cancer. 1997;33(14):2313–2314
  3. Havlik RJ, Yancik R, Long S, Ries L, Edwards B. The National Institute on Aging and the National Cancer Institute SEER collaborative study on comorbidity and early diagnosis of cancer in the elderly. Cancer. 1994;74(7 Suppl):2101–2106
  4. Wingo PA, Cardinez CJ, Landis SH, Greenlee RT, Ries LA, Anderson RN, et al. Long-term trends in cancer mortality in the United States, 1930–1998. Cancer. 2003;97(12 Suppl):3133–3175
  5. Kumar A, Soares HP, Balducci L, Djulbegovic B. Treatment tolerance and efficacy in geriatric oncology: a systematic review of phase III randomized trials conducted by five National Cancer Institute-sponsored cooperative groups. J Clin Oncol. 2007;25(10):1272–1276
  6. Hutchins LF, Unger JM, Crowley JJ, Coltman CA, Albain KS. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999;341(27):2061–2067
  7. Lewis JH, Kilgore ML, Goldman DP, Trimble EL, Kaplan R, Montello MJ, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol. 2003;21(7):1383–1389
  8. Townsley CA, Selby R, Siu LL. Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. J Clin Oncol. 2005;23(13):3112–3124
  9. Townsley CA, Chan KK, Pond GR, Marquez C, Siu LL, Straus SE. Understanding the attitudes of the elderly towards enrolment into cancer clinical trials. BMC Cancer. 2006;6:34
  10. Basche M, Baron A, Eckhardt SG, Balducci L, Persky M, Levin MA, et al. Barriers to enrollment of elderly adults in early-phase cancer clinical trials. J Oncol Pract. 2008;4(4):162–168
  11. Dale DC. Poor prognosis in elderly patients with cancer: the role of bias and undertreatment. J Support Oncol. 2003;1(4 Suppl. 2):11–17
  12. Fentiman IS, Tirelli U, Monfardini S, Schneider M, Festen J, Cognetti F, et al. Cancer in the elderly: why so badly treated?. Lancet. 1990;335(8696):1020–1022
  13. Ramsey SD, Howlader N, Etzioni RD, Donato B. Chemotherapy use, outcomes, and costs for older persons with advanced non-small-cell lung cancer: evidence from surveillance, epidemiology and end results-medicare. J Clin Oncol. 2004;22(24):4971–4978
  14. Owonikoko TK, Ragin CC, Belani CP, Oton AB, Gooding WE, Taioli E, et al. Lung cancer in elderly patients: an analysis of the surveillance, epidemiology, and end results database. J Clin Oncol. 2007;25(35):5570–5577
  15. Townsley C, Pond GR, Peloza B, Kok J, Naidoo K, Dale D, et al. Analysis of treatment practices for elderly cancer patients in Ontario, Canada. J Clin Oncol. 2005;23(16):3802–3810
  16. Janssen-Heijnen ML, Coebergh JW. The changing epidemiology of lung cancer in Europe. Lung Cancer. 2003;41(3):245–248
  17. Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. The Elderly Lung Cancer Vinorelbine Italian Study Group. J Natl Cancer Inst. 1999;91(1):66–72
  18. Frasci G, Lorusso V, Panza N, Comella P, Nicolella G, Bianco A, et al. Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small-cell lung cancer. J Clin Oncol. 2000;18(13):2529–2536
  19. Frasci G, Lorusso V, Panza N, Comella P, Nicolella G, Bianco A, et al. Gemcitabine plus vinorelbine yields better survival outcome than vinorelbine alone in elderly patients with advanced non-small cell lung cancer. A Southern Italy Cooperative Oncology Group (SICOG) phase III trial. Lung Cancer. 2001;34(Suppl. 4):65–69
  20. Gridelli C, Perrone F, Gallo C, Cigolari S, Rossi A, Piantedosi F, et al. 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. J Natl Cancer Inst. 2003;95(5):362–372
  21. Tsukada H, Yokoyama A, Nishiwaki Y, Shinkai T, Harada M, Ando M, et al. Randomized controlled trial comparing docetaxel (D)-cisplatin (P) combination with D alone in eldelry patients (pts) with advanced non-small cell lung cancer (NSCLC): JCOG0207. Proc Am Soc Clin Oncol. 2007;25(18s):[abstr 7629]
  22. Russo A, Rizzo S, Fulfaro F, Adamo V, Santini D, Vincenzi B, et al. Gemcitabine-based doublets versus single-agent therapy for elderly patients with advanced nonsmall cell lung cancer: a literature-based meta-analysis. Cancer. 2009;115(9):1924–1931
  23. Kudoh S, Takeda K, Nakagawa K, Takada M, Katakami N, Matsui K, et al. Phase III study of docetaxel compared with vinorelbine in elderly patients with advanced non-small-cell lung cancer: results of the West Japan Thoracic Oncology Group Trial (WJTOG 9904). J Clin Oncol. 2006;24(22):3657–3663
  24. Langer CJ, Manola J, Bernardo P, Kugler JW, Bonomi P, Cella D, et al. Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial. J Natl Cancer Inst. 2002;94(3):173–181
  25. Langer C, Vangel M, Schiller HJ, Harrington D, Sandler A, Belani CP, et al. Age-specific subanalysis of ECOG 1594: Fit elderly patients (70–80 YRS) with NSCLC do as well as younger pts (<70). Proc Am Soc Clin Oncol. 2003;22:[abstr 2571]
  26. Kelly K, Giarritta S, Akerley W, Hesketh P, Wozniak A, Albain K, et al. Should older patients (Pts) receive combination chemotherapy for advanced stage non-small cell lung cancer (NSCLC)? An analysis of southwest oncology trials 9509 and 9308. Proc Am Soc Clin Oncol. 2001;20(329a):1;[abstr 1313]
  27. Belani CP, Fossella F. Elderly subgroup analysis of a randomized phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for first-line treatment of advanced nonsmall cell lung carcinoma (TAX 326). Cancer. 2005;104(12):2766–2774
  28. Lilenbaum RC, Herndon JE, List MA, Desch C, Watson DM, Miller AA, et al. Single-agent versus combination chemotherapy in advanced non-small-cell lung cancer: the cancer and leukemia group B (study 9730). J Clin Oncol. 2005;23(1):190–196
  29. Hensing TA, Peterman AH, Schell MJ, Lee JH, Socinski MA. 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. Cancer. 2003;98(4):779–788
  30. Goto K, Nishiwaki Y, Saijo N, Takeda K, Katakami N, Kudoh S, et al. The four-arm cooperative study (FACS) for advanced non-small cell lung cancer (NSCLC): a subgroup analysis in elderly patients (pts). Proc Am Soc Clin Oncol. 2006;24(18S):[abstr 7115]
  31. Ansari R, Gonin R, Socinski M, Edelman MJ, Catalano R, Marinucci D, et al. Eldelry subgroup analysis of a radnomized phase 3 trial of gemcitabine (G) in combination with carboplatin (Cb) or paclitaxel (P) compared to paclitaxel plus carboplatin in advanced (stage IIIB, IV) non-small cell lung cancer. Proc Am Soc Clin Oncol. 2007;25(18S):[abstr 7665]
  32. Sederholm C, Hillerdal G, Lamberg K, Kolbeck K, Dufmats M, Westberg R, et al. Phase III trial of gemcitabine plus carboplatin versus single-agent gemcitabine in the treatment of locally advanced or metastatic non-small-cell lung cancer: the Swedish Lung Cancer Study Group. J Clin Oncol. 2005;23(33):8380–8388
  33. Pallis AG, Polyzos A, Boukovinas I, Agelidou A, Lamvakas L, Tsiafaki X, et al. Pooled analysis of elderly patients with non-small cell lung cancer treated with front line docetaxel/gemcitabine regimen: the Hellenic Oncology Research Group experience. J Thorac Oncol. 2008;3(5):505–510
  34. Provencio M, Camps C, Cantos B, Alberola V, Domine M, Isla D, et al. Non-small cell lung cancer in the elderly. J Thorac Oncol. 2007;2(8 suppl. 4):[abstr PD4-2-7]
  35. Weiss GJ, Langer C, Rosell R, Hanna N, Shepherd F, Einhorn LH, et al. 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. J Clin Oncol. 2006;24(27):4405–4411
  36. Gridelli C, Maione P, Illiano A, Piantedosi FV, Favaretto A, Bearz A, et al. Cisplatin plus gemcitabine or vinorelbine for elderly patients with advanced non small-cell lung cancer: the MILES-2P studies. J Clin Oncol. 2007;25(29):4663–4669
  37. Ohe Y, Niho S, Kakinuma R, Kubota K, Ohmatsu H, Goto K, et al. A phase II study of cisplatin and docetaxel administered as three consecutive weekly infusions for advanced non-small-cell lung cancer in elderly patients. Ann Oncol. 2004;15(1):45–50
  38. Feliu J, Martin G, Madronal C, Rodriguez-Jaraiz A, Castro J, Rodriguez A, et al. Combination of low-dose cisplatin and gemcitabine for treatment of elderly patients with advanced non-small-cell lung cancer. Cancer Chemother Pharmacol. 2003;52(3):247–252
  39. Shepherd FA, Rodrigues PJ, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med. 2005;353(2):123–132
  40. Jackman DM, Yeap BY, Lindeman NI, Fidias P, Rabin MS, Temel J, et al. Phase II clinical trial of chemotherapy-naive patients > or = 70 years of age treated with erlotinib for advanced non-small-cell lung cancer. J Clin Oncol. 2007;25(7):760–766
  41. Rajdev L, Camacho F, Hall C, Hopkins U, Gucalp R, Perez-Soler R. A phase II study of erlotinib (E) in previously untreated elderly patients (pts) with inoperable or advanced stage non-small cell lung cancer (NSCLC) cancer and an ECOG PS 0-3. J Clin Oncol. 2008;26;[abstr 19098]
  42. Merimsky O, Cheng C, Reck M, Au S, von Powel J. Erlotinib as 1st-line therapy for elderly patients (pts) with advanced non-small cell lung cancer (NSCLC). J Clin Oncol. 2008;26;[abstr 19016]
  43. Crino L, Cappuzzo F, Zatloukal P, Reck M, Pesek M, Thompson JC, et al. Gefitinib versus vinorelbine in chemotherapy-naive elderly patients with advanced non-small-cell lung cancer (INVITE): a randomized, phase II study. J Clin Oncol. 2008;26(26):4253–4260
  44. Chen Y, Tsai C, Shih J, Perng R, Whang-Peng J. Phase II randomized trial of erlotinib versus vinorelbine in chemotherapy-naive patients with advanced non-small-cell lung cancer aged >/=70 years in Taiwan. J Clin Oncol. 2009;27(15s):[abstr 8051]
  45. Wheatley-Price P, Ding K, Seymour L, Clark GM, Shepherd FA. Erlotinib for advanced non-small-cell lung cancer in the elderly: an analysis of the National Cancer Institute of Canada Clinical Trials Group Study BR.21. J Clin Oncol. 2008;26(14):2350–2357
  46. Reck M, von PJ, Zatloukal P, Ramlau R, Gorbounova V, Hirsh V, et al. Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil. J Clin Oncol. 2009;27(8):1227–1234
  47. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355(24):2542–2550
  48. Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, et al. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol. 2008;26(1):60–65
  49. Leighl N, Zatloukal P, Mezger J, Ramlau R, Archer V, Moore N, et al. Efficacy and safety of first-line bevacizumab (Bv) and cisplatin/gemcitabine (CG) in elderly patients (pts) with advanced non-small cell lung cancer (NSCLC) in the BO17704 study (AVAiL). J Clin Oncol. 2009;27(15s):[abstr 8050]
  50. Jager E, Wu Y, Mezger J, Isla D, Passalacqua R, Stroyakovski DL, et al. Safety of first-line bevacizumab (bv) plus chemotherapy in elderly patients (pts) with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC): MO19390 (SAIL) study group. Ann Oncol. 2008;19(suppl. 8):[abstr 240P]
  51. Gridelli C. Treatment of advanced non small-cell lung cancer in the elderly: from best supportive care to the combination of platin-based chemotherapy and targeted therapies. J Clin Oncol. 2008;26(1):13–15
  52. Albain KS, Crowley JJ, LeBlanc M, Livingston RB. Survival determinants in extensive-stage non-small-cell lung cancer: the Southwest Oncology Group experience. J Clin Oncol. 1991;9(9):1618–1626
  53. Stanley KE. Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst. 1980;65(1):25–32
  54. Pfister DG, Johnson DH, Azzoli CG, Sause W, Smith TJ, Baker S, et al. American Society of Clinical Oncology treatment of unrespectable non-small-cell lung cancer guideline: update 2003. J Clin Oncol. 2004;22(2):330–353
  55. Gridelli C, Aapro M, Ardizzoni A, Balducci L, De MF, Kelly K, et al. Treatment of advanced non-small-cell lung cancer in the elderly: results of an international expert panel. J Clin Oncol. 2005;23(13):3125–3137
  56. Pallis AG, Gridelli C, van Meerbeeck JP, Greillier L, Wedding U, Lacombe D, et al. EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts’ opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Oncol 2009; doi:10.1093/annonc/mdp360. [Epud ahead of print].
  57. Mitry E, Douillard JY, Van CE, Cunningham D, Magherini E, Mery-Mignard D, et al. Predictive factors of survival in patients with advanced colorectal cancer: an individual data analysis of 602 patients included in irinotecan phase III trials. Ann Oncol. 2004;15(7):1013–1017
  58. Figer A, Perez-Staub N, Carola E, Tournigand C, Lledo G, Flesch M, et al. FOLFOX in patients aged between 76 and 80 years with metastatic colorectal cancer: an exploratory cohort of the OPTIMOX1 study. Cancer. 2007;110(12):2666–2671
  59. Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst. 2000;92(7):550–556
  60. Gridelli C, Langer C, Maione P, Rossi A, Schild SE. Lung cancer in the elderly. J Clin Oncol. 2007;25(14):1898–1907
  61. Gridelli C, Maione P, Rossi A, Palazzolo G, Colantuoni G, Rossi E. Management of unfit older patients with advanced NSCLC. Cancer Treat Rev. 2009;35(6):517–521
  62. Balducci L. Geriatric oncology: challenges for the new century. Eur J Cancer. 2000;36(14):1741–1754
  63. Deppermann KM. Influence of age and comorbidities on the chemotherapeutic management of lung cancer. Lung Cancer. 2001;33(Suppl. 1):115–120
  64. Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA. 2004;291(20):2441–2447
  65. Wolfson C, Wolfson DB, Asgharian M, M’Lan CE, Ostbye T, Rockwood K, et al. A reevaluation of the duration of survival after the onset of dementia. N Engl J Med. 2001;344(15):1111–1116
  66. Wedding U, Rohrig B, Klippstein A, Pientka L, Hoffken K. Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients. J Cancer Res Clin Oncol. 2007;133(12):945–950
  67. Repetto L, Fratino L, Audisio RA, Venturino A, Gianni W, Vercelli M, et al. Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study. J Clin Oncol. 2002;20(2):494–502
  68. Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol. 2007;25(14):1824–1831
  69. Carreca I, Balducci L, Extermann M. Cancer in the older person. Cancer Treat Rev. 2005;31(5):380–402
  70. Christman K, Muss HB, Case LD, Stanley V. Chemotherapy of metastatic breast cancer in the elderly. The Piedmont Oncology Association experience. [see comment] JAMA. 1992;268(1):57–62
  71. Kohne CH, Folprecht G, Goldberg RM, Mitry E, Rougier P. Chemotherapy in elderly patients with colorectal cancer. Oncologist. 2008;13(4):390–402
  72. Repetto L, Venturino A, Fratino L, Serraino D, Troisi G, Gianni W, et al. Geriatric oncology: a clinical approach to the older patient with cancer. Eur J Cancer. 2003;39(7):870–880
  73. Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist. 2000;5(3):224–237

PII: S0305-7372(10)00003-4

doi: 10.1016/j.ctrv.2009.12.013

Cancer Treatment Reviews
Volume 36, Issue 5 , Pages 436-441 , August 2010