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Clinical benefit of platinum doublet combination therapy in older adults with advanced non-small cell lung cancer: A prospective multicenter study by the National Hospital Organization in Japan.
Shimokawa, Mototsugu; Kanazu, Masaki; Saito, Ryusei; Mori, Masahide; Tamura, Atsuhisa; Okano, Yoshio; Fujita, Yuka; Endo, Takeo; Motegi, Mitsuru; Takata, Shohei; Kita, Toshiyuki; Sukoh, Noriaki; Mizuki, Fumitaka; Takenoyama, Mitsuhiro; Atagi, Shinji.
Afiliación
  • Shimokawa M; Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
  • Kanazu M; Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
  • Saito R; Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan.
  • Mori M; Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan.
  • Tamura A; Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan.
  • Okano Y; Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
  • Fujita Y; Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan.
  • Endo T; Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan.
  • Motegi M; Department of Respiratory Medicine, National Hospital Organization Mito Medical Center, Ibaraki, Japan.
  • Takata S; Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
  • Kita T; Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan.
  • Sukoh N; Department of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
  • Mizuki F; Department of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan.
  • Takenoyama M; Center for Clinical Research, Yamaguchi University Hospital, Yamaguchi, Japan.
  • Atagi S; Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Thorac Cancer ; 14(17): 1597-1605, 2023 06.
Article en En | MEDLINE | ID: mdl-37073452
BACKGROUND: Previous trials suggest that older adults with non-small cell lung cancer (NSCLC) derive benefit from platinum doublet combination therapy, but its superiority is controversial. Although geriatric assessment variables are used to assess the individual risk of severe toxicity and clinical outcomes in older patients, the standard first-line treatment is still debated. Therefore, we aimed to identify the risk factors for clinical outcomes in older patients with NSCLC. METHODS: Patients aged ≥75 years with advanced NSCLC treated at any of 24 National Hospital Organization institutions completed a pre-first-line chemotherapy assessment, including patient characteristics, treatment variables, laboratory test values, and geriatric assessment variables. We evaluated whether these variables were the risk factors for progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 148 patients with advanced NSCLC were treated with combination therapy (n = 90) or monotherapy (n = 58). Median PFS was 5.3 months and OS was 13.6 months. We identified that hypoalbuminemia (hazard ratio [HR] 2.570, 95% confidence interval [CI]: 1.117-5.913, p = 0.0264) was a risk factor for PFS and monotherapy (HR 1.590, 95% CI: 1.070-2.361, p = 0.0217), lactate dehydrogenase (HR 3.682, 95% CI: 1.013-13.39, p = 0.0478), and high C-reactive protein (HR 2.038, 95% CI: 1.141-3.642, p = 0.0161) were risk factors for OS. The median OS was significantly longer in patients treated with combination therapy than in those who received monotherapy (16.5 months vs. 10.3 months; HR 0.684, 95% CI: 0.470-0.995, p = 0.0453). DISCUSSION: Platinum doublet combination therapy may be beneficial in older patients with NSCLC. Identification of risk factors will assist in the development of a personalized treatment strategy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Antineoplásicos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: Asia Idioma: En Revista: Thorac Cancer Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Singapur
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Antineoplásicos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: Asia Idioma: En Revista: Thorac Cancer Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Singapur