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Age No Bar to Benefits of Lung Cancer Chemotherapy

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NEW YORK JUL 14, 2005 (Reuters Health) - Chemotherapy tends to be as effective and well tolerated among elderly patients with non-small cell lung cancer (NSCLC) as in their younger counterparts, researchers from Taiwan report in the July issue of Chest.

Elderly patients, say the investigators, may be treated suboptimally, and their participation in clinical trials is less than that among younger patients, even though their age group experiences a higher incidence of lung cancer.

Dr. Yuh-Min Chen, at the Taipei Veterans General Hospital, and colleagues reviewed three clinical trials they had conducted among patients with NSCLC, comparing outcomes among patients age 70 years and older with those of younger patients.

The first study involved 17 older patients and 23 younger patients treated with vinorelbine plus gemcitabine. The incidence of grade 3 to 4 anemia was more frequent among the older group (35.35% versus 8.7%).

The second study compared therapy with paclitaxel plus carboplatin with paclitaxel plus gemcitabine. Forty-four patients were 70 or older and 46 were younger. Again, anemia was the only adverse event found to be of higher incidence in the older group.

Seventy patients in each age group took part in the third study, which compared vinorelbine and paclitaxel in cisplatin-based combination chemotherapy regimens. Older patients experienced more treatment-induced toxicity, but the differences between groups was small.

In all three trials, response rates and survival times were not significantly different between age groups.

Dr. Chen's group concludes that "age itself should not preclude an elderly patient from receiving chemotherapy." Treatment choices should be based on "clinical sense, drug toxicity profiles, patient comorbidities, cost considerations and patient preferences."


Chest 2005;128:132-139.

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