Until there are more validated biomarkers to direct treatment decisions, many physicians use patient age to decide what therapy to give their patients. Literature data report that older patients often go undertreated because of concerns for limited tolerance to toxic therapies. A study, published in the November 2012 issue of the International Association for the Study of Lung Cancer’s (IASLC) Journal of Thoracic Oncology, says that fit elderly non-small cell lung cancer (NSCLC) patients should be considered for salvage targeted therapy.
The study looked at 255 NSCLC patients involved in the Biomarker-Integrated Approaches of Targeted Therapy for Lung Cancer Elimination (BATTLE) trial. Subgroups were analyzed comparing age groups 65 and older versus younger than 65 and 70 and older versus younger than 70.
The authors conclude that fit elderly patients should be considered for salvage targeted therapy. As far as toxicity, there was no increased incidence of pneumothorax in patients over 65. There was no difference in overall response rate between any age group or sex. And, there was no difference in progression-free survival between any of the overall age groups.
The authors note that the elderly patients in BATTLE did experience “more nonhematologic toxicities, primarily diarrhea and gastrointestinal complaints, but they were able to undergo diagnostic core needle biopsies and subsequent targeted therapy treatment without increased incidence of pneumothorax or treatment-related mortality.” Of note, the study showed elderly men had both improved disease control rate and progression-free survival compared with younger men.
The lead author of this work is IASLC member Dr. Anne Tsao. Co-authors include IASLC members Dr. Jack Lee, Dr. George Blumenschein, Dr. Roy Herbst, Dr. Edward Kim, Dr. Scott Lippman, Dr. David Stewart, Dr. Ignacio Wistuba and Dr. Waun Ki Hong.