For our 5th video in the GRACE Spanish Lung Cancer Library, Antonio Calles, MD joined GRACE to discuss the most appropriate treatment for elderly patients with advanced NSCLC, and whether age alters the recommendations.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, evaluates a variety of particular systemic treatment agents for possible use in elderly patients.

Drs. Ben Solomon, Leora Horn, & Jack West consider whether immunotherapy might prove to be more problematic when given to a broader population of older and frail patients with advanced lung cancer.

Please feel free to offer comments and raise questions in our Discussion Forums.

Transcript

For early stage NSCLC, the historic standard of care is a lobectomy.  But the reality is that with the median age of patients with new lung cancer a little over 70 and many patients quite sick from their lung cancer, COPD, and/or other medical problems, not every patient is a great candidate for surgery.

It's been over two years since I reported the details from a positive trial for Abraxane (albumin-bound paclitaxel) as a weekly treatment combined with carboplatin and compared with standard "solvent-based" Taxol (paclitaxel) along with carboplatin.  While positive for showing a 8% difference in response rate, which was the primary endpoint, it didn't show a significant difference in overall survival (OS), as revealed in the

A group of investigators at Dana Farber Cancer Institute in Boston, MA recently published a very newsworthy article in the Journal of the American Medical Association (JAMA) that argues that patients with advanced non-small cell lung cancer (NSCLC) who are over 65 don't appear to benefit from the addition of Avastin (bevacizumab) to standard chemotherapy with carboplatin/Taxol (paclitaxel).

Almost two months ago, I wrote about stage IV NSCLC in the elderly. There, I reviewed existing data and focused on the published results of the French study (IFCT-050, aka Quoix study) that showed that elderly patients, just like younger patients, do better with platinum-doublet regimens in the first line than with one drug.