Paclitaxel plus carboplatin improved survival in older patients with advanced NSCLC

ASCO 2010 Annual Meeting

CHICAGO — Weekly paclitaxel in combination with monthly carboplatin significantly improved OS and PFS in patients aged 70 years and older with advanced non-small cell lung cancer when compared with standard single-agent chemotherapy, according to phase 3 data from the IFCT-0501 trial.

“Elderly patients are often not given aggressive treatment out of concern that they will not be able to tolerate it. These results demonstrate that a more intensive regimen given to younger patients can be effective and tolerable in this group,” Elisabeth Quoix, MD, professor of medicine at University Hospital, Strasbourg, France, said during a press conference today at the 2010 ASCO Annual Meeting.

Researchers from the French Intergroup of Thoracic Oncology conducted this phase-3 study because the incidence for advanced NSCLC among older patients continues to increase and current recommendations for single-agent therapies gemcitabine or vinorelbine are outdated. In the study, they compared two treatment arms in 451 patients aged 70 to 89 years with advanced NSCLC: arm A, paclitaxel 90 mg/m² in combination with carboplatin AUC 6 every 4 weeks vs. arm B, gemcitabine 1,150 mg/m² or vinorelbine 30 mg/m².

The study was halted due to interim data suggesting a significant increase in OS among patients assigned combination therapy when compared with those assigned single-agent therapy (10.3 months vs. 6.2 months; P=.00004).

Moreover, median PFS was 6.3 months among patients assigned combination therapy vs. 3.2 months among those assigned to single-agent therapy (HR=0.55; 95%CI, 0.44-0.70; P<.0001).

Moderate to severe neutropenia was more frequent among those in the combination therapy group when compared with those in the single-agent therapy group (47.8% vs. 12.2%). – by Jennifer Southall

The average age of a person with lung cancer in the United States is 71 years, so this data tells us exactly what we need to know about this population. Also, the 4 month improvement in the largest population of patients is very important to us. Dr. Quoix’s trial supports the 2009 edition of the ASCO guidelines stating that age, per say, should not be used as criteria to choose chemotherapy. People older than age 70 should be treated just like anyone else.

– Mark G. Kris, MD
Chief, Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center

For more information:

Quoix E. #2. Presented at: the 2010 ASCO Annual Meeting; June 4-8; Chicago.

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