Article and Video CATEGORIES

Cancer Journey

Search By

Dr. Jack West is a medical oncologist and thoracic oncology specialist who is the Founder and previously served as President & CEO, currently a member of the Board of Directors of the Global Resource for Advancing Cancer Education (GRACE)

 

Older Women with NSCLC Do Better: An Increasingly Consistent Finding
Author
Howard (Jack) West, MD

Over the past few years, sex-based differences in lung cancer have become increasingly recognized as relevant in prognosis overall and potentially in predicting response to treatment, such as EGFR inhibitors and other targeted therapies. At ASCO 2007, a group led by Dr. Kathy Albain, long committed to learning more about sex differences in lung cancer outcomes, presented a review of results from a series of six recent chemotherapy-based trials conducted by the Southwest Oncology Group (SWOG) in the setting of advanced NSCLC, divided by patient sex (abstract here):

Albain sex-based trials list (Click to enlarge)

Among the 1334 patients enrolled in these six trials, 36% were women; having women under-represented on lung cancer trials is unfortunately typical (although better than it used to be in the US, and still much better than in European trials, where women constitute just 10-15% of patients in some studies). Women and men didn't differ in their characteristics going into the trial, such as age, performance status, and stage, but women were a little less likely to have weight loss of 5% of baseline weight or more compared to men (33% vs 41%).

Despite starting out with the same characteristics as the men and experiencing a very similar range and severity of treatment-related side effects as men, women had a significantly better overall survival than men, with a median survival of 11 vs. 8 months, a one year survival of 46% vs. 35%, and a two-year survival of 19% vs. 13% (P = 0.02 for the entire overall survival analysis by sex):

Albain OS curves by sex

But it really wasn't all women. Instead, the better survival was limited to women over 60, while women and men under 60 had a very similar survival:

Albain Sex and Age on SWOG trial

That may sound surprising, but we're seeing more and more that hormonal differences may be pretty important. Next I'll describe some of the mounting evidence that is converging to show that women with high serum estradiol levels (a premenopausal picture) don't do as well as women with low serum estradiol levels most commonly seen in older, post-menopausal women.

Next Previous link

Previous PostNext Post

Related Content

Image
Bladder Cancer Video Library 2024
Video
Dr. Petros Grivas discusses intravesical treatment for patients with nonmuscle invasive, or early-stage, bladder cancer, the importance of participating in clinical trials for bladder cancer, combination therapy options for patients with metastatic or incurable bladder cancer, and the importance of family history of cancer and discussing that history with your doctor.
Image
Case Based Panel
Video
The panel discusses treatment options for a patient diagnosed with EGFR Exon 19 Deletion NSCLC and examines data from the Laura Trial, a patient with a smoking history and diagnosis of small cell lung cancer, and how the Adriatic Study factors into decisions, and a patient with NSCLC adenocarcinoma, and a EGFR Exon 21 L858R Alteration, and how data from the Flaura 2 Trial can impact treatment decisions.
Image
Terapias Dirigidas de Cancer de Pulmón 2024
Video
La Dra. Estelamari Rodríguez presenta información básica sobre el NSCLC EGFR+ y analiza la importancia de las pruebas de biomarcadores en el cáncer de pulmón y ofrece una descripción general de las opciones de tratamiento para la enfermedad EGFR+.  Para ver la playlist completa, de click aquí.        

Forum Discussions

Hello Linda, my name is Alexandra Beneke, I'm the Outreach Manager for GRACE. Your willingness to share your experiences and knowledge with the cancer community is truly inspiring. Your dedication to...

Hi Bluebird,  Welcome to GRACE.  I'm sorry you're going through this scare and hope it's just inflammation or from an infection you didn't know you had. 

 

A CT would be...

Radiation + Brain Operation has just been discarded due to high risk. They will double Tagrisso dosis and then wait to see if it works, then try traditional Chemo. I would...

Hi and welcome to GRACE.  I'm sorry to know you are entering a new stage.  I'm not about to comment just now but wanted to let you know I see your...

Edit to say, we can't give advice but we can comment with views and facts.  :)

 

My first thought is to ask if she has been seen at a large...

Hi Barbro, Welcome to GRACE. I'm sorry you're worrying about this. We aren't able to give feedback on scan reports. Interpreting scan reports in this setting is not only unethical but...

Recent Comments

JOIN THE CONVERSATION
Tagrix FDA Approval
By mariachristian on
Hi Judy! It is so good to…
By JanineT GRACE … on
Tagrix vs Tagrisso
By Dipakchavan on
Hello Linda, my name is…
By AlexandraGBeneke on