Therapy choices among older patients with lung carcinoma: An evaluation of two trials of the cancer and leukemia group B

Caio Max S. Rocha Lima, James E. Herndon, Michael Kosty, Gerald Clamon, Mark R. Green

Research output: Contribution to journalArticle

129 Scopus citations

Abstract

BACKGROUND. Despite a greater risk of malignancy and a higher cancer mortality rate for patients age > 65 years, bias in accruing older patients to clinical trials persists. The results from two National Cancer Institute-approved cooperative group trials (Cancer and Leukemia Group B trial 8931 [CALGB 8931] and CALGB 9130) were analyzed retrospectively to determine the participation, tolerance of treatment, and outcome of patients age > 70 years. METHODS. Five hundred fifteen patients with locally advanced or metastatic non-small cell lung carcinoma participated in two separate, randomized, Phase III clinical trials conducted by CALGB. Retrospective evaluation of patients by four distinct age cohorts (< 50 years, 50-59 years, 60-69 years, and > 70 years) was carried out to determine differences in toxicity, response, and survival. RESULTS. No patients age > 80 were entered on either study, even though there was no age restriction in the study eligibility criteria. No significant differences were seen in response, survival, or continuation of treatment based on age cohort. Significantly increased leukocyte toxicity was seen in older cohorts without a concomitant increase in severe or worse infectious events. CONCLUSIONS. No patients age > 80 were entered on either trial despite their potential eligibility. Patients in the oldest cohort showed no negative impact of age on treatment tolerance, response to treatment, or survival. The aggregate clinical judgment of patients and physicians can identify septuagenarians who should not be denied active consideration for aggressive management of their advanced nonsmall cell lung carcinoma.

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalCancer
Volume94
Issue number1
DOIs
StatePublished - Jan 1 2002

Keywords

  • Age
  • Antineoplastic agents
  • Combined
  • Drug therapy
  • Drug tolerance
  • Nonsmall cell lung carcinoma
  • Survival analyses

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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