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

A. G. Pallis, C. Gridelli, J. P. van Meerbeeck, L. Greillier, U. Wedding, D. Lacombe, J. Welch, C. P. Belani, M. Aapro

Research output: Contribution to journalReview article

113 Citations (Scopus)

Abstract

Non-small-cell lung cancer (NSCLC) represents a common health issue in the elderly population. Nevertheless, the paucity of large, well-conducted prospective trials makes it difficult to provide evidence-based clinical recommendations for these patients. The present paper reviews the currently available evidence regarding treatment of all stages of NSCLC in elderly patients. Surgery remains the standard for early-stage disease, though pneumonectomy is associated with higher incidence of postoperative mortality in elderly patients. Given the lack of demonstrated benefit for the use of adjuvant radiotherapy, it is also not recommended in elderly patients. Elderly patients seem to derive the same benefit from adjuvant chemotherapy as younger patients do, with no significant increase in toxicity. For locally advanced NSCLC, concurrent chemoradiotherapy may be offered to selected elderly patients as there is a higher risk for toxicity reported in the elderly population. Third-generation single-agent treatment is considered the standard of care for patients with advanced/metastatic disease. Platinum-based combination chemotherapy needs to be evaluated in prospective trials. Unfortunately, with the exception of advanced/metastatic NSCLC, prospective elderly-specific NSCLC trials are lacking and the majority of recommendations made are based on retrospective data, which might suffer from selection bias. Prospective elderly-specific trials are needed.

Original languageEnglish (US)
Pages (from-to)692-706
Number of pages15
JournalAnnals of Oncology
Volume21
Issue number4
DOIs
StatePublished - Aug 28 2009

Fingerprint

Expert Testimony
Advisory Committees
Non-Small Cell Lung Carcinoma
Geriatrics
Lung Neoplasms
Population
Therapeutics
Adjuvant Radiotherapy
Pneumonectomy
Selection Bias
Chemoradiotherapy
Adjuvant Chemotherapy
Standard of Care
Combination Drug Therapy
Platinum
Mortality
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology

Cite this

Pallis, A. G. ; Gridelli, C. ; van Meerbeeck, J. P. ; Greillier, L. ; Wedding, U. ; Lacombe, D. ; Welch, J. ; Belani, C. P. ; Aapro, M. / 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. In: Annals of Oncology. 2009 ; Vol. 21, No. 4. pp. 692-706.
@article{87f213c1d1b246eea6a112376bd1d033,
title = "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",
abstract = "Non-small-cell lung cancer (NSCLC) represents a common health issue in the elderly population. Nevertheless, the paucity of large, well-conducted prospective trials makes it difficult to provide evidence-based clinical recommendations for these patients. The present paper reviews the currently available evidence regarding treatment of all stages of NSCLC in elderly patients. Surgery remains the standard for early-stage disease, though pneumonectomy is associated with higher incidence of postoperative mortality in elderly patients. Given the lack of demonstrated benefit for the use of adjuvant radiotherapy, it is also not recommended in elderly patients. Elderly patients seem to derive the same benefit from adjuvant chemotherapy as younger patients do, with no significant increase in toxicity. For locally advanced NSCLC, concurrent chemoradiotherapy may be offered to selected elderly patients as there is a higher risk for toxicity reported in the elderly population. Third-generation single-agent treatment is considered the standard of care for patients with advanced/metastatic disease. Platinum-based combination chemotherapy needs to be evaluated in prospective trials. Unfortunately, with the exception of advanced/metastatic NSCLC, prospective elderly-specific NSCLC trials are lacking and the majority of recommendations made are based on retrospective data, which might suffer from selection bias. Prospective elderly-specific trials are needed.",
author = "Pallis, {A. G.} and C. Gridelli and {van Meerbeeck}, {J. P.} and L. Greillier and U. Wedding and D. Lacombe and J. Welch and Belani, {C. P.} and M. Aapro",
year = "2009",
month = "8",
day = "28",
doi = "10.1093/annonc/mdp360",
language = "English (US)",
volume = "21",
pages = "692--706",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "4",

}

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. / Pallis, A. G.; Gridelli, C.; van Meerbeeck, J. P.; Greillier, L.; Wedding, U.; Lacombe, D.; Welch, J.; Belani, C. P.; Aapro, M.

In: Annals of Oncology, Vol. 21, No. 4, 28.08.2009, p. 692-706.

Research output: Contribution to journalReview article

TY - JOUR

T1 - 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

AU - Pallis, A. G.

AU - Gridelli, C.

AU - van Meerbeeck, J. P.

AU - Greillier, L.

AU - Wedding, U.

AU - Lacombe, D.

AU - Welch, J.

AU - Belani, C. P.

AU - Aapro, M.

PY - 2009/8/28

Y1 - 2009/8/28

N2 - Non-small-cell lung cancer (NSCLC) represents a common health issue in the elderly population. Nevertheless, the paucity of large, well-conducted prospective trials makes it difficult to provide evidence-based clinical recommendations for these patients. The present paper reviews the currently available evidence regarding treatment of all stages of NSCLC in elderly patients. Surgery remains the standard for early-stage disease, though pneumonectomy is associated with higher incidence of postoperative mortality in elderly patients. Given the lack of demonstrated benefit for the use of adjuvant radiotherapy, it is also not recommended in elderly patients. Elderly patients seem to derive the same benefit from adjuvant chemotherapy as younger patients do, with no significant increase in toxicity. For locally advanced NSCLC, concurrent chemoradiotherapy may be offered to selected elderly patients as there is a higher risk for toxicity reported in the elderly population. Third-generation single-agent treatment is considered the standard of care for patients with advanced/metastatic disease. Platinum-based combination chemotherapy needs to be evaluated in prospective trials. Unfortunately, with the exception of advanced/metastatic NSCLC, prospective elderly-specific NSCLC trials are lacking and the majority of recommendations made are based on retrospective data, which might suffer from selection bias. Prospective elderly-specific trials are needed.

AB - Non-small-cell lung cancer (NSCLC) represents a common health issue in the elderly population. Nevertheless, the paucity of large, well-conducted prospective trials makes it difficult to provide evidence-based clinical recommendations for these patients. The present paper reviews the currently available evidence regarding treatment of all stages of NSCLC in elderly patients. Surgery remains the standard for early-stage disease, though pneumonectomy is associated with higher incidence of postoperative mortality in elderly patients. Given the lack of demonstrated benefit for the use of adjuvant radiotherapy, it is also not recommended in elderly patients. Elderly patients seem to derive the same benefit from adjuvant chemotherapy as younger patients do, with no significant increase in toxicity. For locally advanced NSCLC, concurrent chemoradiotherapy may be offered to selected elderly patients as there is a higher risk for toxicity reported in the elderly population. Third-generation single-agent treatment is considered the standard of care for patients with advanced/metastatic disease. Platinum-based combination chemotherapy needs to be evaluated in prospective trials. Unfortunately, with the exception of advanced/metastatic NSCLC, prospective elderly-specific NSCLC trials are lacking and the majority of recommendations made are based on retrospective data, which might suffer from selection bias. Prospective elderly-specific trials are needed.

UR - http://www.scopus.com/inward/record.url?scp=77951498205&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951498205&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdp360

DO - 10.1093/annonc/mdp360

M3 - Review article

C2 - 19717538

AN - SCOPUS:77951498205

VL - 21

SP - 692

EP - 706

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 4

ER -