A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced non-small cell lung cancer

Rafat H. Ansari, Mark A. Socinski, Martin J. Edelman, Chandra Belani, René Gonin, Robert B. Catalano, Donna M. Marinucci, Robert L. Comis, Coleman K. Obasaju, Ruqin Chen, Matthew J. Monberg, Joseph Treat

Research output: Contribution to journalReview article

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Abstract

Purpose: Sufficient data are currently unavailable to assist in defining suitable regimens for patients ≥70 years with advanced non-small cell lung cancer (NSCLC). Methods: Chemonaïve patients with a performance status (PS) of 0 or 1 and stage IIIB or IV NSCLC were randomized to gemcitabine 1000mg/m2 on days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 on day 1; the same schedule of gemcitabine plus paclitaxel 200mg/m2 on day 1; or paclitaxel 225mg/m2 on day 1 plus carboplatin AUC 6.0 on day 1. Cycles were every 21 days up to 6. Efficacy and toxicity results were compared by age groups. Results: Overall survival (OS) between patients <70 years (8.6 months, 95% CI: 7.9, 9.5) and ≥70 years (7.9 months, 95% CI: 7.1, 9.5) was similar. OS was 8.8 months (95% CI: 7.5, 10.3) among patients 70-74 years, 6.5 months (95% CI: 5.6, 9.3) among patients 75-79 years, and 7.9 months (95% CI: 6.3, 10.3) among patients ≥80 years. OS was lower among patients 75-79 years compared with patients 70-74 years (P=0.04). Compared with patients <70 years, patients ≥70 years experienced similar rates of myelosuppresion, but younger patients experienced more vomiting and nausea. There was no clear pattern with respect to differences in efficacy by treatments across age groups. Conclusions: Based on the similarity of patient outcomes across age groups, doublet chemotherapy is feasible among carefully selected elderly patients with good PS.

Original languageEnglish (US)
Pages (from-to)162-171
Number of pages10
JournalCritical Reviews in Oncology/Hematology
Volume78
Issue number2
DOIs
StatePublished - May 1 2011

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gemcitabine
Carboplatin
Paclitaxel
Non-Small Cell Lung Carcinoma
Age Groups
Area Under Curve
Survival

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Geriatrics and Gerontology

Cite this

Ansari, Rafat H. ; Socinski, Mark A. ; Edelman, Martin J. ; Belani, Chandra ; Gonin, René ; Catalano, Robert B. ; Marinucci, Donna M. ; Comis, Robert L. ; Obasaju, Coleman K. ; Chen, Ruqin ; Monberg, Matthew J. ; Treat, Joseph. / A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced non-small cell lung cancer. In: Critical Reviews in Oncology/Hematology. 2011 ; Vol. 78, No. 2. pp. 162-171.
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title = "A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced non-small cell lung cancer",
abstract = "Purpose: Sufficient data are currently unavailable to assist in defining suitable regimens for patients ≥70 years with advanced non-small cell lung cancer (NSCLC). Methods: Chemona{\"i}ve patients with a performance status (PS) of 0 or 1 and stage IIIB or IV NSCLC were randomized to gemcitabine 1000mg/m2 on days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 on day 1; the same schedule of gemcitabine plus paclitaxel 200mg/m2 on day 1; or paclitaxel 225mg/m2 on day 1 plus carboplatin AUC 6.0 on day 1. Cycles were every 21 days up to 6. Efficacy and toxicity results were compared by age groups. Results: Overall survival (OS) between patients <70 years (8.6 months, 95{\%} CI: 7.9, 9.5) and ≥70 years (7.9 months, 95{\%} CI: 7.1, 9.5) was similar. OS was 8.8 months (95{\%} CI: 7.5, 10.3) among patients 70-74 years, 6.5 months (95{\%} CI: 5.6, 9.3) among patients 75-79 years, and 7.9 months (95{\%} CI: 6.3, 10.3) among patients ≥80 years. OS was lower among patients 75-79 years compared with patients 70-74 years (P=0.04). Compared with patients <70 years, patients ≥70 years experienced similar rates of myelosuppresion, but younger patients experienced more vomiting and nausea. There was no clear pattern with respect to differences in efficacy by treatments across age groups. Conclusions: Based on the similarity of patient outcomes across age groups, doublet chemotherapy is feasible among carefully selected elderly patients with good PS.",
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A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced non-small cell lung cancer. / Ansari, Rafat H.; Socinski, Mark A.; Edelman, Martin J.; Belani, Chandra; Gonin, René; Catalano, Robert B.; Marinucci, Donna M.; Comis, Robert L.; Obasaju, Coleman K.; Chen, Ruqin; Monberg, Matthew J.; Treat, Joseph.

In: Critical Reviews in Oncology/Hematology, Vol. 78, No. 2, 01.05.2011, p. 162-171.

Research output: Contribution to journalReview article

TY - JOUR

T1 - A retrospective analysis of outcomes by age in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel vs. paclitaxel plus carboplatin for advanced non-small cell lung cancer

AU - Ansari, Rafat H.

AU - Socinski, Mark A.

AU - Edelman, Martin J.

AU - Belani, Chandra

AU - Gonin, René

AU - Catalano, Robert B.

AU - Marinucci, Donna M.

AU - Comis, Robert L.

AU - Obasaju, Coleman K.

AU - Chen, Ruqin

AU - Monberg, Matthew J.

AU - Treat, Joseph

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Purpose: Sufficient data are currently unavailable to assist in defining suitable regimens for patients ≥70 years with advanced non-small cell lung cancer (NSCLC). Methods: Chemonaïve patients with a performance status (PS) of 0 or 1 and stage IIIB or IV NSCLC were randomized to gemcitabine 1000mg/m2 on days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 on day 1; the same schedule of gemcitabine plus paclitaxel 200mg/m2 on day 1; or paclitaxel 225mg/m2 on day 1 plus carboplatin AUC 6.0 on day 1. Cycles were every 21 days up to 6. Efficacy and toxicity results were compared by age groups. Results: Overall survival (OS) between patients <70 years (8.6 months, 95% CI: 7.9, 9.5) and ≥70 years (7.9 months, 95% CI: 7.1, 9.5) was similar. OS was 8.8 months (95% CI: 7.5, 10.3) among patients 70-74 years, 6.5 months (95% CI: 5.6, 9.3) among patients 75-79 years, and 7.9 months (95% CI: 6.3, 10.3) among patients ≥80 years. OS was lower among patients 75-79 years compared with patients 70-74 years (P=0.04). Compared with patients <70 years, patients ≥70 years experienced similar rates of myelosuppresion, but younger patients experienced more vomiting and nausea. There was no clear pattern with respect to differences in efficacy by treatments across age groups. Conclusions: Based on the similarity of patient outcomes across age groups, doublet chemotherapy is feasible among carefully selected elderly patients with good PS.

AB - Purpose: Sufficient data are currently unavailable to assist in defining suitable regimens for patients ≥70 years with advanced non-small cell lung cancer (NSCLC). Methods: Chemonaïve patients with a performance status (PS) of 0 or 1 and stage IIIB or IV NSCLC were randomized to gemcitabine 1000mg/m2 on days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 on day 1; the same schedule of gemcitabine plus paclitaxel 200mg/m2 on day 1; or paclitaxel 225mg/m2 on day 1 plus carboplatin AUC 6.0 on day 1. Cycles were every 21 days up to 6. Efficacy and toxicity results were compared by age groups. Results: Overall survival (OS) between patients <70 years (8.6 months, 95% CI: 7.9, 9.5) and ≥70 years (7.9 months, 95% CI: 7.1, 9.5) was similar. OS was 8.8 months (95% CI: 7.5, 10.3) among patients 70-74 years, 6.5 months (95% CI: 5.6, 9.3) among patients 75-79 years, and 7.9 months (95% CI: 6.3, 10.3) among patients ≥80 years. OS was lower among patients 75-79 years compared with patients 70-74 years (P=0.04). Compared with patients <70 years, patients ≥70 years experienced similar rates of myelosuppresion, but younger patients experienced more vomiting and nausea. There was no clear pattern with respect to differences in efficacy by treatments across age groups. Conclusions: Based on the similarity of patient outcomes across age groups, doublet chemotherapy is feasible among carefully selected elderly patients with good PS.

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