title: Can we predict the development of serious adverse events (SAEs) and early treatment termination in elderly non-small cell lung cancer (NSCLC) patients receiving platinum-based chemotherapy?
abstract: OBJECTIVE
  Predicting the feasibility of platinum-based chemotherapy remains an important issue in elderly (over 70 years) patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify the risk factors for the early serious adverse events (SAEs) (during cycles 1-2) in elderly receiving platinum-based chemotherapy, and to explore the clinical characteristics of patients who require early treatment termination without progressive disease (PD).
  
  
  METHODS
  One hundred and ninety-eight consecutive elderly NSCLC patients receiving platinum-based chemotherapy were retrospectively reviewed.
  
  
  RESULTS
  The median age was 73 years (range 70-83). 161 (81 %) were males, and 190 (95 %) were PS 0-1. Fifty-one (29 %) and 39 (19 %) patients developed early non-hematological SAEs and hematological SAEs, respectively. Multivariate analysis identified low serum albumin (<3.0 g/dl) as an independent risk factor for non-hematological SAEs, while low creatinine clearance (<45 ml/min) for hematological SAEs. In all, 24 (12 %) patients needed early treatment termination without PD. The major reason for this event was the development of non-hematological SAEs (4.5 %), followed by grade 2 non-hematological adverse events (AEs) (3 %). In multivariate analysis, age over 75 years and low serum albumin were associated with this event. The median overall survival (OS) in patients with this event was only 6.0 months, while the development of early SAE was not associated with poor OS.
  
  
  CONCLUSIONS
  Baseline serum albumin might be useful for predicting the feasibility of platinum-based chemotherapy, and the risk estimation of early treatment termination without PD might be beneficial for the treatment selection in elderly NSCLC patients.
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. morisem@med.nagoya-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Morise
authors.affiliation: Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ando
authors.affiliation: Department of Respiratory Medicine, Komaki Municipal Hospital, Komaki, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kojima
authors.affiliation: Department of Respiratory Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ogasawara
authors.affiliation: Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Ryujiro
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Joe
authors.initials: J
authors.lastname: Shindoh
authors.affiliation: Department of Respiratory Medicine, Ichinomiya Municipal Hospital, Ichinomiya, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Japan.
authors.forename: Yasuteru
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: Department of Respiratory Medicine, Handa City Hospital, Handa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Respiratory Medicine, Chukyo Hospital, Nagoya, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nozaki
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Tetsunari
authors.initials: T
authors.lastname: Hase
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies
chemical_list: D016190:Carboplatin; D002945:Cisplatin
keywords: Elderly; Non-small cell lung cancer; Platinum-based chemotherapy; Serious adverse event