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Elderly, chemotherapy, lung cancer

Marianna Christodoulou, Fiona Blackhall, Hitesh Mistry, Ahmet Leylek, Joost Knegjens, Vincent Remouchamps, Isabelle Martel-Lafay, Nuria Farré, Matjaz Zwitter, Delphine Lerouge, Nicolas Pourel, Henri Janicot, Arnaud Scherpereel, Caroline Tissing-Tan, Karin Peignaux, Xavier Geets, Krzysztof Konopa, Corinne Faivre-Finn
INTRODUCTION: There is a lack of data on the efficacy and safety of concurrent chemo-radiotherapy in elderly, limited-stage, patients with small cell lung cancer. METHODS: We compared outcomes of patients aged ≥70 years vs. younger patients within the Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) trial. Patients were randomised to receive 45Gy/30 twice-daily fractions/3 weeks or 66Gy/33 once-daily fractions/6.5 weeks concurrently with platinum-based chemotherapy...
October 11, 2018: Journal of Thoracic Oncology
Biao Gu, Jipeng Wang, Yaqi Song, Qi Wang, Qingquan Wu
BACKGROUND: Administering epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) tyrosine kinase inhibitor (TKI) combined with chemotherapy in patients with non-small cell lung cancer (NSCLC) is a common treatment strategy. However, the prognostic factors for the EGFR-TKI combined with chemotherapy in smokers with NSCLC are still uncertain. PATIENTS AND METHODS: In this retrospective study, we enrolled patients with stage IV NSCLC diagnosed between June 2011 and March 2015 at two university-affiliated hospitals in China...
October 28, 2018: Journal of Cellular Biochemistry
Chunrong Wu, Bo Li, Guiyin Sun, Chunfang Peng, Debing Xiang
Background: Advanced non-small-cell lung cancer (NSCLC) is a huge challenge for physicians. Traditional chemoradiotherapy is associated with high rates of toxicities, especially when treating gerontal patients. Our study was focused on investigating the safety and efficacy of permanent iodine-125 seed implantation and chemotherapy for the treatment of advanced NSCLC in the elderly. Methods: Fifty elderly patients with stage III or IV NSCLC at our hospital from January 2011 to June 2017 were treated with the chemotherapy regimens (paclitaxel/cisplatin) and computed tomography (CT)-guided iodine-125 brachytherapy (group A), 50 patients who received chemotherapy consisting of paclitaxel and cisplatin only (group B) were matched-up with the patients in group A...
2018: OncoTargets and Therapy
Tateaki Naito, Shuichi Mitsunaga, Satoru Miura, Noriatsu Tatematsu, Toshimi Inano, Takako Mouri, Tetsuya Tsuji, Takashi Higashiguchi, Akio Inui, Taro Okayama, Teiko Yamaguchi, Ayumu Morikawa, Naoharu Mori, Toshiaki Takahashi, Florian Strasser, Katsuhiro Omae, Keita Mori, Koichi Takayama
BACKGROUND: Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme. METHODS: This was a multicentre prospective single-arm study...
October 18, 2018: Journal of Cachexia, Sarcopenia and Muscle
Eric D Miller, James L Fisher, Karl E Haglund, John C Grecula, Meng Xu-Welliver, Erin M Bertino, Kai He, Peter G Shields, David P Carbone, Terence M Williams, Gregory A Otterson, Jose G Bazan
BACKGROUND: To compare patterns of care for elderly patients versus non-elderly patients with non-surgically treated stage III non-small cell lung cancer (NSCLC) using the National Cancer Database (NCDB). We hypothesize that elderly patients are less likely to receive curative treatments, including concurrent chemoradiation (CCRT), compared to non-elderly patients. METHODS: We identified patients from the NCDB between 2003 and 2014 with non-surgically treated stage III NSCLC...
October 5, 2018: Radiation Oncology
Takako Mouri, Tateaki Naito, Ayumu Morikawa, Noriatsu Tatematsu, Satoru Miura, Taro Okayama, Katsuhiro Omae, Koichi Takayama
Objective: Physical activity (PA) may improve the quality of life (QOL) of cancer survivors. However, the impact on patients with advanced cancer with high cachectic potential is unknown. We analyzed the feasibility of PA intervention using the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) and the impact on QOL in elderly patients with advanced cancer. Methods: We recruited 30 patients aged ≥70 years who were scheduled to receive the first-line chemotherapy for newly diagnosed advanced pancreatic or non-small-cell lung cancer...
October 2018: Asia-Pacific Journal of Oncology Nursing
Ayumu Morikawa, Tateaki Naito, Miwa Sugiyama, Taro Okayama, Takashi Aoyama, Akira Tanuma, Katsuhiro Omae, Toshiaki Takahashi
Objective: New or worsening disability can develop in elderly patients in just 1 week of hospitalization for acute illness. Elderly patients with cancer, particularly those with cancer cachexia, are vulnerable to disability. This study aimed to explore the impact of hospitalization and cachexia on physical activity (PA) in elderly patients during chemotherapy. Methods: We prospectively enrolled 18 patients aged ≥70 years with newly-diagnosed, advanced non-small-cell lung cancer scheduled to initiate first-line chemotherapy...
October 2018: Asia-Pacific Journal of Oncology Nursing
T Almodovar, E Teixeira, A Barroso, M Soares, H J Queiroga, J Cavaco-Silva, F Barata
Cancer is primarily a disease of the elderly, with the incidence of older patients with cancer expected to increase in the coming years. Despite remarkable advances during the last decade, lung cancer remains a leading cause of mortality worldwide, non-small cell lung cancer (NSCLC) being the dominant (85-90%) subtype. At diagnosis, 50% of NSCLC patients are ≥70 years and 15%, over 80 years of age. Due to their under-representation in clinical trials, current treatment decisions for older patients with cancer are based on a low level of scientific evidence...
September 25, 2018: Pulmonology
Eduard Teixidor, Elia Sais, Carmen Amalia Vásquez, Walter Carbajal, Alejandro Hernández, Gloria Sánchez, Angel Izquierdo, Sara Verdura, Javier A Menéndez, Joaquim Bosch-Barrera
Advances in immunotherapy have changed the therapeutic landscape of non-small cell lung cancer (NSCLC), extending overall survival over standard chemotherapy. However, by removing the protection against autoimmunity, immunotherapy can increase immune-related adverse events (irAEs). In addition, new patterns of radiological response have been observed in patients treated with immune checkpoint inhibitors (ICIs). We report the case of a 77 year-old patient with advanced lung adenocarcinoma, who presented three consecutive different irAEs (nephritis, hepatitis, and pneumonitis) and an atypical radiological response (partial response, dissociated response, and "disease flare") in relation to treatment with the PD-1 inhibitor nivolumab...
August 31, 2018: Oncotarget
Ikuko Shimabukuro, Shingo Noguchi, Kazuhiro Uyama, Ryo Torii, Hiroshi Ishimoto, Chiharu Yoshii, Fumihiro Tanaka, Kazuhiro Yatera, Hiroshi Mukae
OBJECTIVE: A retrospective analysis on carboplatin(CBDCA)/nanoparticle albumin-boundpaclitaxel(nab-PTX)combination chemotherapy was conducted in patients with non-small-cell lung cancer(NSCLC)to evaluate both the efficacy and toxicity based on age, treatment line, histology, and underlying diseases. SUBJECTS: A total of 27 patients with advanced or recurrent NSCLC following surgery who receivedCBDCA /nab-PTX as first- andsecond -line combination chemotherapy, respectively, were investigatedfrom March 2013 to December 2015...
September 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Michela D'Ascanio, Aldo Pezzuto, Chiara Fiorentino, Bruno Sposato, Pierdonato Bruno, Alessio Grieco, Rita Mancini, Alberto Ricci
Background: Lung cancer is the leading cause of death worldwide. The treatment choice for advanced stage of lung cancer may depend on histotype, performance status (PS), age, and comorbidities. In the present study, we focused on the effect of metronomic vinorelbine treatment in elderly patients with advanced unresectable non-small cell lung cancer (NSCLC). Methods: From January 2016 to December 2016, 44 patients affected by non-small cell lung cancer referred to our oncology day hospital were progressively analyzed...
2018: BioMed Research International
Xue-Song Zhang, Kui-Yang Wang, Jin-Qi Gao, Ruo-Jie Li, Qing-Bo Guan, Lei Song
The aim of the study was to investigate the expression of tumor suppressor gene p53 and MMP-9 in non-small cell lung cancer (NSCLC) before and after chemotherapy, and investigate its association with the effect of chemotherapy and prognosis. Fifty-eight elderly NSCLC patients comprised the observation group. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of p53 and MMP-9 in lung cancer tissues before and after chemotherapy. Immunohistochemistry and western blot analysis were used to detect the expression of p53 and MMP-9 proteins in NSCLC tissue before and after chemotherapy...
October 2018: Oncology Letters
Hideyuki Sone, Satoshi Igawa, Masashi Kasajima, Mikiko Ishihara, Yasuhiro Hiyoshi, Shinji Hosotani, Shuntaro Ohe, Hiroki Ito, Nobuki Kaizuka, Hiroya Manaka, Tomoya Fukui, Hisashi Mitsufuji, Masaru Kubota, Masato Katagiri, Jiichiro Sasaki, Katsuhiko Naoki
BACKGROUND: Previous studies have shown amrubicin (AMR) to be an effective second-line treatment option for small-cell lung cancer (SCLC). However, the efficacy of AMR in elderly patients with relapsed SCLC has not been sufficiently evaluated. METHODS: The medical records of elderly patients with relapsed SCLC who received AMR as second-line chemotherapy were retrospectively reviewed, and their treatment outcomes were evaluated. RESULTS: Thirty-one patients with a median age of 72 years (22 patients with sensitive relapse and 9 with refractory relapse) were analyzed...
October 2018: Thoracic Cancer
Grazia Lazzari, Angela Terlizzi, Giovanna Porrazzo, Salvatore Devicienti, Francesco Perri, Giuseppina Della Vittoria Scarpati, Giovanni Silvano
Advanced squamous cell lung carcinoma in elderly patients has a limited chance of cure with first, second line chemotherapy and radiotherapy. Radiotherapy in advanced non-small-cell lung cancer can be used with curative intent for localized or oligometastatic disease using standard or altered fractionations. Current evidence indicates that radiotherapy via diverse cascade mechanisms is able to invoke both local and systemic immunoresponses promoting tumor cell death through an in situ vaccination effect. Moreover, the advancement in immunotherapies is changing the scenario...
2018: OncoTargets and Therapy
Yusuke Chihara, Koji Date, Yoshizumi Takemura, Nobuyo Tamiya, Yoshihito Kohno, Tatsuya Imabayashi, Yoshiko Kaneko, Tadaaki Yamada, Mikio Ueda, Taichiro Arimoto, Junji Uchino, Yoshinobu Iwasaki, Koichi Takayama
This phase I study was aimed at determining the maximum tolerated dose (MTD) and recommended dose (RD) for oral S-1 plus paclitaxel combination therapy in elderly patients with non-small cell lung cancer (NSCLC). Chemotherapy-naïve patients (age, >70 years) with stage III/IV NSCLC were treated with paclitaxel intravenously at four dose levels (DLs), 60, 70, 80, and 90 mg/m2 , on day 1 and 8, and with S-1 (80 mg/m2 ) orally on days 1-14 every 3 weeks. MTD was defined as the dose at which two of the initial three patients experienced dose-limiting toxicities (DLTs)...
August 18, 2018: Investigational New Drugs
Hisao Imai, Yutaka Yamada, Tomohide Sugiyama, Hiroyuki Minemura, Kyoichi Kaira, Kenya Kanazawa, Takashi Kasai, Takayuki Kaburagi, Koichi Minato
BACKGROUND/AIMS: More than 50% of patients with lung cancer are aged > 65 years, and non-small-cell lung cancer (NSCLC) accounts for 85% of all cases of lung cancer among both elderly and adult patients. Subsequent therapies confound the capability to discern the effect of first-line chemotherapy on overall survival (OS). Therefore, using individual-level data, our study aimed to determine the relationships of progression-free survival (PFS) and post-progression survival (PPS) with OS after first-line epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in elderly patients with NSCLC harboring sensitive EGFR mutations...
2018: Chemotherapy
Fabio Gomes, Rebecca Tay, Jaseela Chiramel, Raffaele Califano
Lung cancer is predominantly a disease of the elderly. This subgroup of patients poses many challenges and an appropriate geriatric assessment is crucial for treatment personalisation in order to reduce the risk of over- or under-treatment. Whilst cytotoxic chemotherapy has been the backbone of advanced non-small cell lung cancer (NSCLC) treatment for decades, the development of targeted agents for driver mutations such as EGFR, ALK, BRAF and ROS1 has changed the treatment paradigm and natural history of this disease...
September 2018: Drugs & Aging
Yun-Gyoo Lee, Ju Hyun Lee, Se-Hyun Kim, Yu Jung Kim, Heeyoung Lee, Soyeon Ahn, Joung-Soon Jang, Jong-Seok Lee, Jee Hyun Kim
INTRODUCTION: To determine whether an upfront combination compared to single-agent therapy is beneficial for elderly patients with advanced non-small cell lung cancer (NSCLC) in the real world, a population-based epidemiologic study was conducted. METHODS: Patients ≥70 years with advanced NSCLC from 2007 to 2012 were identified in the National Health Insurance Service Database of Korea. A Cox proportional-hazards regression model and propensity score analysis were used to examine the effect of treatment modality on survival...
August 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Cesare Gridelli, Alessandro Morabito, Luigi Cavanna, Andrea Luciani, Paolo Maione, Laura Bonanno, Virginio Filipazzi, Silvana Leo, Saverio Cinieri, Fortunato Ciardiello, Marco Angelo Burgio, Domenico Bilancia, Diego Cortinovis, Francesco Rosetti, Roberto Bianco, Vittorio Gebbia, Fabrizio Artioli, Roberto Bordonaro, Vittorio Fregoni, Manlio Mencoboni, Fabrizio Nelli, Ferdinando Riccardi, Giuditta di Isernia, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Simona Signoriello, Maria Carmela Piccirillo, Ciro Gallo, Francesco Perrone
Purpose To test the efficacy of adding cisplatin to first-line treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC) within a combined analysis of two parallel phase III trials, MILES-3 and MILES-4. Patients and Methods Patients with advanced NSCLC who were older than age 70 years with Eastern Cooperative Oncology Group performance status 0 to 1 were randomly assigned to gemcitabine or pemetrexed, without or with cisplatin. In each trial, 382 events were required to detect a hazard ratio (HR) of death of 0...
September 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Juliet A Carmichael, Daisy Wing-San Mak, Mary O'Brien
Until recently, chemotherapy has remained the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC). Excellent responses have been observed with immune-checkpoint inhibitors, and targeted treatments for those tumours with actionable mutations, resulting in a paradigm shift in the treatment approach for these patients. Elderly patients and those with poor performance status (PS), such as Eastern Cooperative Oncology Group (ECOG) 2, have historically been excluded from clinical trials due to poor outcomes...
July 18, 2018: Cancers
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