123P - Outcomes of octogenarian (≥80 yo) patients with advanced non-small cell lung cancer (NSCLC): A single institution experience from The Christie Hos...

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Geriatric Oncology
Non-Small-Cell Lung Cancer, Metastatic
Presenter Matthew Howell
Citation Annals of Oncology (2015) 26 (suppl_1): 29-44. 10.1093/annonc/mdv050
Authors M. Howell, J. Chiramel, N. Flaum, A. Lewis, Y. Summers, P. Taylor, A. Chittalia, H. Sheikh, F.H. Blackhall, R. Califano
  • Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/UK

Abstract

Aim/Background

The majority of advanced NSCLC patients (pts) are ≥70 years old. Platinum-based doublet chemotherapy is recommended to treat advanced NSCLC in fit, non-elderly adults, but monotherapy is recommended for patients ≥70 years old. There are no specific guidelines for treatment of pts > 80 yo. 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 ≥80 yo treated at The Christie between February 2008 and December 2013. Data retrieved: demographics, performance status (PS), treatment type and survival. Primary outcome: percentage (%) of pts receiving systemic anticancer treatment (SACT). Secondary outcomes: % receiving palliative radiotherapy (RT) or best supportive care (BSC), % of pts stopping SACT due to toxicity, and median overall survival (OS).

Results

235 pts were identified. Median age was 85 (range 80-96), 65% were male. PS was 0, 1, 2, 3, or 4 in 4%, 25%, 41%, 23% and 2% of patients, respectively. Histology: Adenocarcinoma/Squamous/Bronchialveolar carcinoma/NOS: 23%/38%/3%/36%. Two percent of pts (13% of pts tested) were EGFR mutant. 86% of pts receiving SACT had PS of 0-1. 85% had stage 3-4 disease. Treatment administered: RT (75%), BSC (19%) and SACT (6%). First-line SACT: single agent gemcitabine (14%), vinorelbine (7%), carboplatin-based doublet (57%) and gefitinib (21%). 50% started SACT at a reduced dose. All pts experienced toxicity (21% had grade 3-4). 57% stopped treatment due to toxicity or worsening PS. 29% completed only 1 cycle of chemotherapy and 42% completed ≥3 cycles. Median OS was 10.3, 5.2, 7.7, 5.1 and 3.2 months for doublet chemotherapy, single agent chemotherapy, EGFR-TKI, palliative RT and BSC, respectively.

Conclusions

Our series demonstrates that only a very small % of octogenarian pts received SACT and 50% stopped treatment early due to toxicity. In pts who received chemotherapy, OS was in keeping with reported series unselected with regards to age.

Disclosure

All authors have declared no conflicts of interest.