This despite clear survival with any chemotherapy, and platinum-based regimens in particular
WEDNESDAY, March 31 (HealthDay News) -- Elderly patients with advanced non-small-cell lung cancer are not likely to receive chemotherapy, and platinum-based doublet regimens in particular, despite their clear survival benefits, according to a study published online March 29 in the Journal of Clinical Oncology.
Amy J. Davidoff, Ph.D., from the University of Maryland in Baltimore, and colleagues analyzed data from 21,285 patients with advanced non-small-cell lung cancer, of whom 25.8 percent received first-line chemotherapy, with a focus on outcomes after platinum-doublet therapy (two-drug platinum-based regimens) compared with single-agent therapy.
After adjusting for various factors, the researchers found that patients who were older, had comorbidities, and had poor performance status were less likely to receive any chemotherapy and platinum-based doublet regimens. This was despite a reduced risk of death (adjusted hazard ratio, 0.558) and increased adjusted one-year survival (27.0 versus 11.6 percent) with any chemotherapy. Compared with single-agent therapy, platinum-doublet therapy reduced the risk of death (adjusted hazard ratio, 0.734) and increased adjusted one-year survival (30.1 versus 19.4 percent).
"Most elderly patients with advanced non-small-cell lung cancer do not receive chemotherapy, yet there are clear survival benefits, even with controls for age, comorbidity, and performance status," Davidoff and colleagues conclude. "The benefit of platinum-based doublet regimens is greater than single-agent chemotherapy."
The study was supported by a grant from Sanofi-Aventis. One author is an employee of Sanofi-Aventis, and Davidoff reported receiving research funding from Sanofi-Aventis.
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