Author of

• 11001

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  P1.24 - Poster Session 1 - Clinical Care (ID 146)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11040

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    P1.24-039 - Outcome of a series of 25 consecutive patients aged 84 and more with stage IV NSCLC : an invitation to systemic treatment (ID 2827)

    09:30 - 09:30  |  Author(s): R. Stenger
    • Abstract

    Background
    Elderly patients and even more older elderly with stage IV NSCLC are often not optimally treated.

    Methods
    Not applicable

    Results
    Between april 1[st] 2010 and february 28th 2013, 25 patients ( aged 84 years or more were referred with a stage IV (11 M1a and 14 M1b) non-small cell lung cancer to our university hospital. There were 11 females and 14 males. There were 11 never-smokers. Median age was 87 years (range : 84-92). Histological subtypes were : 8 squamous cell carcinoma, 14 adenocarcinoma and 3 large cell carcinoma. Molecular analyses was performed in 17 cases among which 2 were impossible due to inappropriate biopsy specimen. EGFR- mutations were found in 4 female patients, 1 with exon 19 deletion and 3 with exon 21 point mutations. There were 3 K-RAS mutations and no ALK translocations. 6 patients received TKIs as first line treatment (5 gefitinib and 1 erlotinib). Two patients with no molecular analysis were treated with first-line TKI (both of them had PS 4, one died after 1.1 month, the other recovered very quickly and is still alive after 15.3 months). The other patients were treated with doublet carboplatine AUC 6 and weekly paclitaxel (90 mg/m², D1, 8, 15), with D1 = D29 (12 patients) or single agent therapy (paclitaxel (2), Gemcitabine (1), vinorelbine(1)). Three patients received only best supportive care (BSC). Doses of TKIs had to be lowered due to toxicity in 1 case. Median overall survival was 8.1 months with a one-year probability of survival of 46%. Survival of the 6 patients treated with first-line TKIs was 1.1, 3.1+, 6.43+, 14, 15.33+, 15.9+ months.

    Conclusion
    It must be noted that EGFR-mutations were more frequent compared to younger patients (at least 4/25) paralleling the high proportion of never-smokers (44%) and of female patients (44%). In this unselected consecutive series of older elderly patients, only 3 received BSC as sole treatment, while 4 were treated with single agent chemotherapy, 12 with a carboplatine-based doublet and 6 with TKIs as first line therapy, of which only 4 had proven EGF-R mutations. Survival was very similar to what is observed with younger counterparts and thus, nihilism is not appropriate in this category of patients.