Comparison of platinum-based chemotherapy in patients older and younger than 70 years: an analysis of Southwest Oncology Group Trials 9308 and 9509.
OBJECTIVE
This retrospective analysis sought to investigate the safety, feasibility, and outcomes of platinum doublet therapy in patients aged 70 years or older with advanced non-small cell lung cancer compared with patients younger than 70 years who participated in two randomized phase III trials conducted by the Southwest Oncology Group.


METHODS
Outcomes and toxicity data from fit patients with stage IIIB or stage IV non-small cell lung cancer treated with cisplatin/vinorelbine and carboplatin/paclitaxel were pooled from Southwest Oncology Group trials 9308 (S9308) and 9509 (S9509) and compared with respect to age.


RESULTS
A total of 616 patients were available for efficacy analyses, of which 122 (20%) were aged 70 years or older. The median progression-free survival was 4 months in both age groups (p = 0.71), and response rates were similar. Overall survival was significantly higher in the younger patient cohort (median 9 months versus 7 months, p = 0.04). Individual parameters of toxicity were similar in both age groups.


CONCLUSIONS
Although patients aged 70 years or older derived initial benefit from platinum-based therapy, survival was better in younger patients. Additional studies in this growing patient population are needed to develop treatment strategies that minimize toxicity and increase efficacy.
St. Elizabeth's Medical Center, Boston, Massachusetts 02135, USA. blanchard.eliz@gmail.com
Elizabeth M
EM
Blanchard
James
J
Moon
Paul J
PJ
Hesketh
Karen
K
Kelly
Antoinette J
AJ
Wozniak
John
J
Crowley
David
D
Gandara
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine