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Should Elderly Non-Small-Cell Lung Cancer Patients be Offered ElderlySpecific Trials? Results of a Pooled Analysis from the North Central Cancer Treatment Group.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • Aminah Jatoi
  • Shauna L Hillman
  • Philip J Stella, MD
  • Erin Green
  • Alex A Adjei
  • Suresh G. Nair, MD, Lehigh Valley Health Network
  • Edith A Perez, MD
  • Bipinkur Amin
  • Steven E Schild
  • Rene Castillo
  • James R Jett
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PURPOSE: To answer the question, "should elderly non-small-cell lung cancer patients be offered elderly-specific trials?"

PATIENTS AND METHODS: The North Central Cancer Treatment Group (NCCTG) performed a pooled analysis of elderly patients who participated in elderly-specific trials (required age > or = 65 years) and age-unspecified trials (required age > or = 18 years). Between 1998 and 2000, all NCCTG non-small-cell lung cancer (NSCLC) patients with incurable cancer, age > or = 65 years, and receiving first-line chemotherapy were included. A total of 118 elderly patients participated in elderly-specific trials, and 108, in age-unspecified trials. Demographics and outcomes were compared based on trial type.

RESULTS: The median age of elderly patients in elderly-specific trials was greater: median (range): 73 years (65 to 87) and 70 years (65 to 85), respectively (P < .001), as was the percentage older than 80 years: 17% and 3%, respectively (P = .0008). Median survival times were 232 and 302 days, respectively (P = .08). After adjustment for baseline age, Eastern Cooperative Oncology Group performance score, cancer stage, and body mass index, this survival difference was not statistically significant (hazard ratio = 1.25; P = .16). Grade 3 or worse nonhematologic adverse event rates were greater in age-unspecified trials (81% v 57%, respectively; P < .001), as were grade 3 or worse hematologic events (68% v 10%, respectively; P < .001).

CONCLUSION: Elderly patients in NSCLC elderly-specific trials suffered lower rates of severe adverse events with no statistically significant differences in survival. It seems that elderly-specific trials are providing quality care and helping to define optimal cancer therapy in the elderly, particularly among the "oldest of the old."

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Citation Information

Jatoi, A., Hillman, S., Stella, P., Green, E., Adjei, A., Nair, S., & ... Jett, J. R. (2005). Should Elderly Non-Small-Cell Lung Cancer Patients be Offered Elderly-Specific Trials? Results of a Pooled Analysis from the North Central Cancer Treatment Group. Journal Of Clinical Oncology: Official Journal Of The American Society Of Clinical Oncology, 23(36), 9113-9119.