P2.03a-043 A Retrospective Analysis of the Chemotherapy for ‘Very Old' Patients Aged 80 Years and Order with Advanced Lung Cancer: Topic: Clinical Trials

Abstract

The number of elderly patients with lung cancer is increasing, and it is becoming a public health problem in Japan. There is little data on the efficacy and safety of chemotherapy for patients aged 80 and older, even though they constitute 30% of all lung cancer incidence (80-84 years, 16%; 85years and older, 14.4%) reported by cancer information service, National Cancer Center, Japan in 2012. The objective of this study was to evaluate the efficacy and safety of chemotherapy in patients aged 80 and older with advanced lung cancer in our hospital, retrospectively. The medical records were analyzed from January 2010 to July 2016. In total, 27 patients were analyzed. Patient characteristics were below; the median ages were 81 years (range, 80-84); female/ male: 8/19, PS 0-1/ 2: 22/5, adenocarcinoma/ squamous/ NOS (not otherwise specified) /SCLC: 7/8/1/11, stageIII/ IV/ recurrence: 3/19/5. Platinum-doublets, mono-chemotherapy were used in 15, 12 patients, respectively. In platinum-doublets, the median number of cycle was 4 (range 1-6) and dose reduction was conducted in 4 of 11 patients (36%) receiving at least 2 cycles. CBDCA+ETP was administered for 11 SCLC patients. The response rate was 45% and median PFS was 4.1months (95% CI: 1.2-4.9). Four patients with NSCLC used platinum-doublets; CBDCA+nab-PTX/ CBDCA+PEM: 1/3. There were no patients who achieved objective response and the median PFS was 3.0 months (95% CI: 2.2-6.5). Among 2 of 4 patients, treatment discontinuation due to the deterioration of depression and bone fracture arose. Treatment related death (TRD) was observed in 2 patients with PS-2 (13%). Mono-chemotherapy was administered in 12 patients; VNR/ DTX/ PEM: 7/ 4/ 1. The median number of cycle was 3.5 (range 1-13) and dose reduction was conducted in 2 patients (20%). No TRD was observed. The response rate and disease control rate was 8% and 91%, and median PFS was 6.4months (95% CI: 1.8-12.2). Grade 3 or more hematological toxicities tended to be more frequent in platinum-doublets than mono-chemotherapy, but febrile neutropenia was frequent in both groups; neutropenia 93%/75%, thrombocytopenia 33%/0%, febrile neutropenia 20%/33%. After discontinuation of first line therapy, the subsequent chemotherapy was more frequently administered in mono-chemotherapy than platinum-doublets (58% vs 40%). The chemotherapy for patients aged 80 and older could be well tolerated in most cases, but patient selection should be more carefully conducted than younger patients.