title: Differential effect of age on survival in advanced NSCLC in women versus men: analysis of recent Eastern Cooperative Oncology Group (ECOG) studies, with and without bevacizumab.
abstract: BACKGROUND
  The impact of age on prognosis in advanced stage non-small cell lung cancer (NSCLC) may differ by sex.
  
  
  METHODS
  Eligible patients (N=1590) from E1594, a 4-arm platinum-based chemotherapy trial, and E4599 (carboplatin/paclitaxel ± bevacizumab) chemotherapy arm were divided into male and female cohorts and separated into age groups of <60 or ≥60 years old. Eligible E4599 patients (N=850) were similarly separated by age and sex and by treatment (± bevacizumab). Survival was calculated separately for each cohort.
  
  
  RESULTS
  The median survival time (MST) for women ≥60 years old treated with chemotherapy alone on E1594 and E4599 was 11.6 months versus 9.0 months for women <60 (p=0.03). MST was 7.4 and 8.3 months for men ≥60 and <60 years old respectively (NS). In E4599 the age <60 by bevacizumab treatment interaction was statistically significant (p=0.03) for women (younger had greater benefit), with no age effect in men.
  
  
  CONCLUSIONS
  In this unplanned, exploratory subgroup analysis of advanced stage NSCLC ECOG trials, women ≥60 years old treated with chemotherapy live longer than men and younger women. In contrast, bevacizumab survival benefit was more pronounced in men of any age and in younger women on E4599.
authors.affiliation: Department of Medicine/Division of Oncology, Stanford University, Stanford, CA, USA. hwakelee@stanford.edu
authors.forename: H A
authors.initials: HA
authors.lastname: Wakelee
authors.forename: S E
authors.initials: SE
authors.lastname: Dahlberg
authors.forename: J R
authors.initials: JR
authors.lastname: Brahmer
authors.forename: J H
authors.initials: JH
authors.lastname: Schiller
authors.forename: M C
authors.initials: MC
authors.lastname: Perry
authors.forename: C J
authors.initials: CJ
authors.lastname: Langer
authors.forename: A B
authors.initials: AB
authors.lastname: Sandler
authors.forename: C P
authors.initials: CP
authors.lastname: Belani
authors.forename: D H
authors.initials: DH
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012737:Sex Factors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab