Chemotherapy Improves Survival in Elderly Patients with NSCLC

An analysis conducted on elderly patients with advanced-stage non-small-cell lung cancer (NSCLC) found that chemotherapy increases overall survival (OS) in patients ≥80 years (Lung Cancer. 2021 Feb 16;154:62-68.).

“There are limited data on the role for chemotherapy in patients > 80 years old with advanced-stage non-small cell lung carcinoma. We used the National Cancer Database (NCDB) to evaluate treatment patterns and outcomes for patients ≥80 years old with advanced NSCLC,” explained Zaheer Ahmed, Department of Hematology and Oncology, Medical University of South Carolina, Charleston.

Between 2004 and 2014, researchers identified metastatic NSCLC patients and divided them into two groups: those under the age of 80 (n = 218,365) and those 80 years or older (n = 33,352).

Continuous variables were compared using t-test, and categorical variables were compared using chi-square or Fisher's exact test. Researchers performed multivariable (MV) and propensity-matched analyses to analyze the impact of chemotherapy on overall survival.

Of the 33,352 NSCLC patients 80 or older, only 29% received chemotherapy. However, those treated with chemotherapy had an OS of 8 months, compared to 2 months among patients not receiving chemotherapy (HR 0.46; CI 0.45-0.47; P < .001). Additionally, MV analysis showed chemotherapy was beneficial for all age subgroups (80-84 years, 85-89 years, and 90+ years; P < .0001).

There was slight improvement in 1-year survival amongst patients receiving multiagent chemotherapy (35.5% v.s 32.8% with single-agent chemotherapy; HR 0.92; CI 0.88-0.96; P < .001). Although chemotherapy proved beneficial for patients age ≥ 80 years, the proportion of them receiving chemotherapy did not increase over time. 

“Chemotherapy improved overall survival in ≥80 years old patients with advanced-stage NSCLC. Despite improved survival and an increase in the proportion of ≥80 years old patients diagnosed with advanced NSCLC, less than one-third receive chemotherapy,” concluded Dr Ahmed et al.—Alexandra Graziano

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