1258P - Can we predict severe adverse events (SAEs) and clarify unfit populations for platinum-based chemotherapy in elderly patients (over 70 years of age...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Geriatric Oncology
Non-Small-Cell Lung Cancer, Metastatic
Presenter Toshio Kato
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors T. Kato1, M. Morise1, M. Ando2, E. Kojima3, T. Ogasawara4, R. Suzuki5, J. Shindoh6, M. Matsumoto7, Y. Sugino8, M. Ogawa9, Y. Nozaki10, M. Kondo1, H. Saito11, Y. Hasegawa1
  • 1Department Of Respiratory Medicine, Nagoya University Graduate School of Medicine, 466-8550 - Nagoya/JP
  • 2Center For Advanced Medicine And Clinical Research, Nagoya University Hospital, Nagoya/JP
  • 3Department Of Respiratory Medicine, Komaki Municipal Hospital, Komaki/JP
  • 4Department Of Respiratory Medicine, NagoyaDaini Red Cross Hospital, Nagoya/JP
  • 5Department Of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi/JP
  • 6Departmetn Of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki/JP
  • 7Department Of Respiratory Medicine, Ichinomiya Municipal Hospital, Ichinomiya/JP
  • 8Department Of Respiratory Medicine, Toyota Memorial Hospital, Toyota/JP
  • 9Department Of Respiratory Medicine, Handa city hospital, Handa/JP
  • 10Department Of Respiratory Medicine, Chukyo Hospital, Nagoya/JP
  • 11Department Of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, 444-0011 - Okazaki/JP

Abstract

Aim

Platinum-based therapy has shown survival benefits in elderly patiients with NSCLC. The aim of this multicenter retrospective cohort study was to identify the risk factors for the development of SAEs and explore the prediction of elderly patients unfit for platinum-based therapy.

Methods

Data of 198 consecutive elderly patients treated with platinum-based therapy between 2010 and 2012 were reviewed. Unfit elderly was defined as patients who developed an event of early termination of treatment (in 1-2 cycles) without disease progression. We focused on non-hematological (non-H)-SAEs (grade 3-5) and hematological (H)-SAEs (grade 4-5) in early phase (1-2 cycles), and explored the association between AEs and early termination of treatment.

Results

Patient characteristics were as follows: male/female 161/37; median age 73 years (range 70-83); PS 0-1/2 190/8; non squamous cell carcinoma (Sq)/Sq 144/54. The majority of drugs in combination were pemetrexed (42%) and paclitaxel (30%). The median overall survival (OS) was 11.9 months. 44 (22%) and 39 (19%) developed non-H- and H-SAEs in early phase, respectively. Multivariate analysis identified the baseline low serum albumin (low Alb) (≤3.0 g/dl) as an independent risk factor for the development of non-H-SAEs [adjusted odds ratio (AOR): 2.75, (95% CI: 1.18-6.30)], while the baseline low creatinine clearance (<45 ml/min) for the development of H-SAEs [AOR: 6.13, (95% CI: 1.63-25.48)]. 24 (12%) were identified as unfit elderly. The major reason for treatment termination was non-H SAEs (38%) followed by grade 2 non-H AEs (25%). The higher age (≥75 years) [AOR: 3.83, (95% CI: 1.41-11.13)] and the low Alb [AOR: 5.58, (95% CI: 1.83-17.39)] were independent factors for predicting unfit elderly. The median OS for unfit elderly was only 6.0 months.

Conclusions

In addition to non-H-SAEs, grade 2 non-H-AEs affected the continuation of platinum-based therapy. Baseline Alb would be useful for predicting the risk of non-H-SAEs and unfit elderly in platinum-based therapy.

Disclosure

Y. Hasegawa: Dr. Hasegawa reported receiving honoraria for lecturing from Eli Lilly and Company. All other authors have declared no conflicts of interest.