Author of

• 17556

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  P2.03a - Poster Session with Presenters Present (ID 464)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17597

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    P2.03a-041 - Comparison between Combination and Mono Chemotherapy for Elderly Patients with Advanced Non-Small Cell Lung Cancer: A Population-Based Study (ID 4921)

    14:30 - 14:30  |  Author(s): J.H. Lee
    • Abstract

    Background:
    Despite the elderly patients represents the majority of lung cancer population, only 10~20% of study patients in clinical trials were elderly. Moreover, the studies examining combination versus single-agent therapy in an elderly with advanced non-small cell lung cancer (NSCLC) have showed conflicting results in terms of survival benefit. This population-based analyses aimed to assess the pattern of initial chemotherapeutic regimen and the survival benefit of combination chemotherapy compared with single-agent in elderly patients with advanced NSCLC.
    
    Methods:
    Patients ³ 70 years with advanced NSCLC incident from 2007 to 2012 were identified in the National Health Insurance Service database of Korea. Multivariate models examined the patient characteristics associated with receipt of combination compared with single-agent chemotherapy. Cox proportional-hazards regression model was used to examine the effect of treatment modality on survival. Propensity score analysis adjusted for confounding.
    
    Results:
    Among 41276 patients with de novo lung cancer, 8274 (20.0%) who received palliative chemotherapy were eligible for this study. Of 8274 patients with advanced NSCLC, 7298 (88.2%) who received cytotoxic chemotherapy were included in further analyses, except 976 (11.8%) who received first-line EGFR tyrosine kinase inhibitor. A total of 5636 (77.2%) patients received combination chemotherapy and 1662 (22.8%) received monotherapy. The most frequent regimen was gemcitabine + platinum doublet (44.7%) in combination group and gemcitabine single (46.7%) in monotherapy group. Multivariate analyses indicated that the lower use of combination chemotherapy with increasing age (odds ratio[OR] 0.73; 95% CI 0.67 to 0.79; P < .001) and female (OR 0.71; 95% CI 0.62 to 0.80; P < .001). Receipt of combination over single-agent chemotherapy was associated with reduction in the adjusted hazard of death (hazard ratio[HR] 0.91; 95% CI 0.86 to 0.96; P=0.001) and an increase in median overall survival from 9.7 to 10.8 months. In the propensity-matched cohort, survival was still significantly better in combination chemotherapy group (HR 0.89; 95% CI 0.80 to 0.98; P = .019 by stratified Log-rank test).
    
    Conclusion:
    In elderly patients with advanced NSCLC who are eligible for cytotoxic chemotherapy, there are clear survival benefit of combination chemotherapy compared with single-agent with controls for age, sex and comorbidity.