1260P - Outcomes of elderly patients (≥70 yo) with advanced non-small cell lung cancer (NSCLC): A multi-institutional analysis

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Geriatric Oncology
Non-Small-Cell Lung Cancer, Metastatic
Presenter Noor-Ul-Ain Tariq
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors N. Tariq1, V. Bertaglia2, N. Shah3, T. Mele2, R. Alamgir3, N. Khan3, Y. Summers4, P.D. Taylor4, M. Harris5, N. Bayman5, H. Sheikh5, A. Chittalia5, L. Pemberton6, L. Lee5, J. Coote5, C. Faivre-Finn5, G. Scagliotti2, F.H. Blackhall1, S. Novello2, R. Califano7
  • 1Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 2Oncology, San Luigi Hospital, Turin/IT
  • 3Medical Oncology, The Christie NHS Foundation Trust, Manchester/GB
  • 4Medical Oncology, The Christie NHS Foundation Trust & University Hospital South Manchester NHS Foundation Trust, Manchester/GB
  • 5Clinical Oncology, The Christie NHS Foundation Trust, Manchester/GB
  • 6Clinical Oncology, The Christie NHS Foundation Trust & University Hospital South Manchester NHS Foundation Trust, Manchester/GB
  • 7Department Of Medical Oncology, The Christie NHS Foundation Trust & University Hospital South Manchester NHS Foundation Trust, Manchester/GB

Abstract

Aim

Themajority of advanced NSCLC patients (pts) are ≥70 years old. International guidelines recommend use of single agent chemotherapy or, for fit patients with good organ function, platinum-based doublets. This patient group is under-represented in clinical trials and undertreated in clinical practice.

Methods

We retrospectively analysed all consecutive pts with advanced NSCLC and ≥70 yo treated at The Christie, Manchester, UK and San Luigi Hospital, Turin, Italy between January 2007 and December 2012. Data retrieved: demographics, performance status (PS), type of treatment, lines of treatment, response rate (RR) and date of progression/death. Primary outcome: percentage (%) of pts receiving systemic anticancer treatment (SACT). Secondary outcomes: % receiving palliative RT or best supportive care (BSC) only, % of pts stopping treatment due to toxicity, RR from first-line systemic ant-cancer therapy (SACT) and median overall survival (OS) calculated with Kaplan-Meier curves.

Results

623 pts were identified. Median age was 75 (range 70-93), 63.4% were male. PS was 0, 1, 2, 3, 4 and unknown in 20.9%, 26.3%, 30%, 20.7%, 1.9% and 0.2% of pts, respectively. Histology: Adenocarcinoma/Squamous/Bronchialveolar carcinoma/NOS: 34.7%/34.2%/26.5%/0.8%/3.8%. 3% of all pts (11% of tested non-squamous) were EGFR mutant. Treatment given: SACT (37%), palliative RT (45%) and BSC (18%). First-line SACT: single agent gemcitabine, vinorelbine, carboplatin, etoposide, pemetrexed and docetaxel (17.8%), platinum based-doublet 76.5%; (carboplatin-based 69.1%, cisplatin-based 7.4%) and gefitinib/erlotinib (EGFR-TKI) (5.7%). Treatment was stopped due to toxicity in 7.9% of pts (all had chemotherapy). Response rate to first-line: PR 9.8%, SD 20%. Second-line and third-line treatment were given to 9.8% and 3% of patients, respectively. Median OS was 10.4, 6.7, 17.8, 4.7 and 2.3 months for doublet chemotherapy, single agent chemotherapy, EGFR-TKI, palliative radiotherapy and BSC, respectively.

Conclusions

In our series, 37% of pts received SACT with good tolerability. OS was in keeping with reported series unselected with regards to age; highlighting that fit elderly pts can tolerate and benefit from SACT.

Disclosure

All authors have declared no conflicts of interest.