Weekly carboplatin and paclitaxel in elderly non-small-cell lung cancer patients (>or=65 years of age): a phase II North Central Cancer Treatment Group study.

The purpose of this study was to determine the tumor response rate and toxicity profile of low-dose weekly carboplatin and paclitaxel in advanced non-small-cell lung cancer (SCLC) patients 65 or more years of age. Forty-nine patients 65 years of age or more with advanced non-SCLC with a median age of 73 years (range: 65-85) and an Eastern Cooperative Oncology Group performance status of 0, 1, or 2 in 31%, 47%, and 22% of patients, respectively, were treated and evaluated. Patients received carboplatin (AUC = 2) and paclitaxel 50 mg/m2 on days 1, 8, and 15 of a 4-week cycle. The overall confirmed tumor response rate was 14% (95% CI: 4.7%, 32.5%) with no complete responses. The 1-year survival rate was 31% (95% CI: 20%, 48%). There was one treatment-related death, and there were two grade IV allergic reactions to chemotherapy. No other grade IV or V treatment-related toxicities were observed. There were only three episodes of grade III myelosuppression. Low-dose weekly carboplatin and paclitaxel, as prescribed in this trial, provides modest activity in the treatment of advanced non-SCLC patients 65 or more years of age. However, the relatively mild toxicity profile observed in this trial suggests that this regimen might remain an option for patients at increased risk for myelosuppression or with a poor performance status.

Daily activities: exploring their spectrum and prognostic impact in older, chemotherapy-treated lung cancer patients.

BACKGROUND: Performance scores predict benefits and toxicities from chemotherapy. Among older cancer patients, however, many investigators have empirically called for a detailed assessment of activities of daily living, claiming that the utility of performance scores is limited in this older population. This study's goals were therefore twofold: (1). to explore the predictive capability of an activities questionnaire and of performance score with respect to chemotherapy's toxicity and efficacy; (2). to describe the daily activities of older patients as they undergo chemotherapy for incurable metastatic lung cancer. METHODS: As part of a multi-institutional therapeutic trial, this study included 48 patients >or=65 years of age with metastatic non-small-cell lung cancer. All were assigned an Eastern Cooperative Oncology Group (ECOG) performance score and completed an activity questionnaire (Voorrips) prior to the initiation of carboplatin and paclitaxel. Patients were monitored for toxicity (CTC, version 2) and cancer status. RESULTS: Within this cohort, ECOG performance scores were poor at predicting grade 3 or worse toxic events ( P=0.71, Mantel-Haenszel chi-squared). In contrast, the activity questionnaire categories did predict grade 3 or worse toxicity ( P=0.03) with a positive association observed between greater levels of activity and lower toxicity rates. Neither instrument predicted 90-day disease progression, although there was a trend that suggested a positive association between favorable scores and lower progression rates ( P=0.051). Patients described a broad range of daily activities. CONCLUSION: Activity questionnaires capture a broad range of data that may prove useful in predicting toxicity among older cancer patients.