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Time-to-Treatment-Failure and Related Outcomes among 1000+ Advanced Non-Small Cell Lung Cancer Patients: Comparisons Between Older Versus Younger Patients
Journal of Thoracic Oncology ( IF 20.4 ) Pub Date : 2018-07-01 , DOI: 10.1016/j.jtho.2018.03.020
Ajeet Gajra , Tyler J. Zemla , Aminah Jatoi , Josephine L. Feliciano , Melisa L. Wong , Hongbin Chen , Ronald Maggiore , Ryan P. McMurray , Arti Hurria , Hyman B. Muss , Harvey J. Cohen , Jacqueline Lafky , Martin J. Edelman , Rogerio Lilenbaum , Jennifer G. Le-Rademacher

Introduction: Time‐to‐treatment‐failure (TTF) is the interval from chemotherapy initiation to premature discontinuation. We evaluated TTF based on age. Methods: Pooled analyses were conducted with first‐line chemotherapy trials for advanced NSCLC (CALGB 9730, 30203, and 30801). Comparisons among patients who were 65 years and older and 70 years and older were performed for TTF (primary endpoint), reasons for early chemotherapy cessation, grade 3+ adverse events, and overall survival. Results: Among 1006 patients, 460 (46%) were older than 65 years of age. One hundred forty‐five older patients (32% of this age cohort) completed all six planned chemotherapy cycles as did 170 (32%) younger patients. Median TTF was 2.9 months (95% confidence interval: 2.7– 3.2) in older patients and 3 months (95% confidence interval: 2.9–3.5) in younger patients; adjustment for performance status and stratification by chemotherapy by trial yielded no statistically significant age‐based difference in TTF. However, reasons for early chemotherapy cessation differed between age groups (multivariate p = 0.004). Older patients were less likely to discontinue from cancer progression (41% versus 55%) and more likely from toxicity or patient choice (16% and 15%, respectively) compared to younger patients (13% and 6%, respectively). Older patients were more likely to experience grade 3+ adverse events (86% versus 79%) with no statistically significant difference in survival. An age cutpoint of 70+ years showed no difference in TTF, a lower trend of early cessation due to cancer progression, and somewhat shorter older patient survival. Conclusions: TTF was comparable between older and younger patients; but different, age‐based, and potentially modifiable reasons account for it.

中文翻译:

1000 多名晚期非小细胞肺癌患者的治疗失败时间和相关结果:老年患者与年轻患者的比较

简介: 治疗失败时间(TTF)是指从化疗开始到过早停药的时间间隔。我们根据年龄评估了 TTF。方法:对晚期 NSCLC 的一线化疗试验(CALGB 9730、30203 和 30801)进行汇总分析。对 65 岁及以上和 70 岁及以上患者的 TTF(主要终点)、早期停止化疗的原因、3+ 级不良事件和总生存率进行了比较。结果:在 1006 名患者中,460 名 (46%) 的年龄超过 65 岁。145 名老年患者(占该年龄组的 32%)和 170 名(32%)年轻患者完成了所有六个计划的化疗周期。老年患者的中位 TTF 为 2.9 个月(95% 置信区间:2.7-3.2),年轻患者为 3 个月(95% 置信区间:2.9-3.5);通过试验对体能状态和化疗分层进行调整后,TTF 在年龄上没有显着差异。然而,早期化疗停止的原因因年龄组而异(多变量 p = 0.004)。与年轻患者(分别为 13% 和 6%)相比,老年患者不太可能停止癌症进展(41% 对 55%),更有可能因毒性或患者选择(分别为 16% 和 15%)而停止治疗。年龄较大的患者更有可能出现 3+ 级不良事件(86% 对 79%),生存率无统计学差异。70 岁以上的年龄分界点显示 TTF 没有差异,由于癌症进展而早期停止的趋势较低,老年患者的生存期略短。结论:老年和年轻患者的 TTF 具有可比性;但不同,
更新日期:2018-07-01
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