Cancer in the Older Population: Elderly Often Excluded from Treatment Trials
Study Shows Older Patients Can Tolerate Aggressive Therapy
PHILADELPHIA (May 30, 2003) — Elderly cancer patients are underrepresented or excluded from cancer chemotherapy clinical trials in the U.S. largely because of concerns that these patients cannot tolerate aggressive chemotherapy regimens. According to a study presented at the American Society of Clinical Oncology Annual Meeting, elderly patients with non-small-cell lung cancer who are fit are able to tolerate aggressive chemotherapy regimens as readily as younger patients.
"Because of the perception that elderly patients cannot tolerate aggressive chemotherapy, physicians often prescribe a single treatment agent or just supportive care for non-small-cell lung cancer," said Corey Langer, M.D., director of thoracic medical oncology at Fox Chase Cancer Center and the study's lead author. "This study shows that perception to be false." Results of the study will be presented in a poster session on May 31 at 9:00 a.m.
For the study, researchers conducted a sub-analysis of 1,139 medical records of patients with non-small-cell lung cancer enrolled in an Eastern Cooperative Oncology Group clinical trial (ECOG 1594). Patients in the study were randomized to one of four treatment arms (cisplatin + paclitaxel, cisplatin + gemcitabine, cisplatin + docetaxel, and carboplatin + paclitaxel).
Of the 1,139 patients, 227 patients were 70 years of age or older and 912 were younger than 70. The overall survival outcome did not favor a specific regimen in this study. The median and overall survival rates of older patients were comparable to those in the younger patients treated with the same agents. When comparing results in older patients and younger patients, researchers found no difference in the response rate to the drugs.
"The older patients tolerated the regimens as well as the younger patients in this study," Langer said. "Our finding adds to the body of evidence that fit elderly patients being treated for non-small-cell lung cancer can tolerate more aggressive chemotherapy than previously believed." Langer adds, "The need to include older cancer patients in clinical trials is underscored by the fact that one-third of the newly diagnosed non-small-cell lung cancer patients are 70 years of age or older. As long as elderly patients are underrepresented in clinical trials, it will be difficult to properly evaluate the efficacy and safety of current treatment options."
Non-small-cell lung cancer, a slow-growing cancer, accounts for 80 to 85 percent of the 170,000 cases of lung cancer diagnosed in the United States each year. Forty-two percent of those newly diagnosed with non-small-cell lung cancer are over 65 years of age.
Fox Chase Cancer Center, part of Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase also was among the first institutions to receive the National Cancer Institute’s prestigious comprehensive cancer center designation in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are routinely recognized in national rankings, and the Center’s nursing program has achieved Magnet status for excellence three consecutive times. Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research and oversees programs in cancer prevention, detection, survivorship, and community outreach. For more information, call 1-888-FOX-CHASE (1-888-369-2427).