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Can we predict the development of serious adverse events (SAEs) and early treatment termination in elderly non-small cell lung cancer (NSCLC) patients receiving platinum-based chemotherapy?

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

Predicting the feasibility of platinum-based chemotherapy remains an important issue in elderly (over 70 years) patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify the risk factors for the early serious adverse events (SAEs) (during cycles 1–2) in elderly receiving platinum-based chemotherapy, and to explore the clinical characteristics of patients who require early treatment termination without progressive disease (PD).

Methods

One hundred and ninety-eight consecutive elderly NSCLC patients receiving platinum-based chemotherapy were retrospectively reviewed.

Results

The median age was 73 years (range 70–83). 161 (81 %) were males, and 190 (95 %) were PS 0–1. Fifty-one (29 %) and 39 (19 %) patients developed early non-hematological SAEs and hematological SAEs, respectively. Multivariate analysis identified low serum albumin (<3.0 g/dl) as an independent risk factor for non-hematological SAEs, while low creatinine clearance (<45 ml/min) for hematological SAEs. In all, 24 (12 %) patients needed early treatment termination without PD. The major reason for this event was the development of non-hematological SAEs (4.5 %), followed by grade 2 non-hematological adverse events (AEs) (3 %). In multivariate analysis, age over 75 years and low serum albumin were associated with this event. The median overall survival (OS) in patients with this event was only 6.0 months, while the development of early SAE was not associated with poor OS.

Conclusion

Baseline serum albumin might be useful for predicting the feasibility of platinum-based chemotherapy, and the risk estimation of early treatment termination without PD might be beneficial for the treatment selection in elderly NSCLC patients.

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Acknowledgments

This work was supported by Central Japan Lung Study Group.

Author information

Author notes

    Authors and Affiliations

    1. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

      Toshio Kato, Masahiro Morise, Tetsunari Hase, Masashi Kondo & Yoshinori Hasegawa

    2. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan

      Masahiko Ando

    3. Department of Respiratory Medicine, Komaki Municipal Hospital, Komaki, Japan

      Eiji Kojima

    4. Department of Respiratory Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan

      Tomohiko Ogasawara

    5. Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan

      Ryujiro Suzuki

    6. Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan

      Joe Shindoh

    7. Department of Respiratory Medicine, Ichinomiya Municipal Hospital, Ichinomiya, Japan

      Masami Matsumoto

    8. Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Japan

      Yasuteru Sugino

    9. Department of Respiratory Medicine, Handa City Hospital, Handa, Japan

      Masahiro Ogawa

    10. Department of Respiratory Medicine, Chukyo Hospital, Nagoya, Japan

      Yasuhiro Nozaki

    11. Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan

      Hiroshi Saito

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    1. Toshio Kato
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    Corresponding author

    Correspondence to Masahiro Morise.

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    Conflict of interest

    All authors have received no funding support for this work. Information about financial relationships outside the work is as follows: Dr. Morise has received speaking honoraria from Chugai Pharmaceutical Co., TAIHO Pharmaceutical Co., Eli Lilly Japan, and Pfizer Inc.; Dr. Ando has received speaking honoraria from Merck Serono Co.; Dr. Ogasawara has received speaking honoraria from Pfizer Inc., KYORIN Pharmaceutical Co., Glaxo Smith Kline K.K., Novartis Pharma Co., Meiji Seika Pharma Co., and Boehringer Ingerheim; Dr. Shindo has received speaking honoraria from Daiichi Sankyo, KYORIN Pharmaceutical Co., TAIHO PHARMACEUTICAL CO., MSD K.K., Kyowa Hakko Kirin co., Glaxo Smith Kline K.K., and Nippon Boehringer Ingelheim Co; Dr. Matsumoto has received speaking honoraria from TEIJIN LIMITED., Philips Respironics GK., Chugai Pharmaceutical Co., and DAIICHI SANKYO Co; Dr. Sugino has received speaking honoraria from Astellas Pharma Inc., Ono Pharmaceutical Co., Shionogi & Co., Abbott Japan Co., Ltd., MSD K.K., Sanofi, GlaxoSmithKline plc., Mitsubishi Tanabe Pharma., Pfizer Inc., Novartis Pharma K.K., AstraZeneca, and KYORIN Pharmaceutical Co.; Dr. Hase has received speaking honoraria from Chugai Pharmaceutical Co., AstraZeneca, Boehringer Ingerheim, Novartis Pharma, DAIICHI SANKYO COMPANY; Dr. Kondo has received speaking honoraria from Chugai Pharmaceutical Co., AstraZeneca, Boehringer Ingerheim, Novartis Pharma K.K., TAIHO Pharmaceutical Co., Pfizer Inc., and Eli Lily Japan K.K.; Dr. Saito reported a grant from ONO PHARMACEUTICAL CO., Merck Serno, TAIHO Pharmaceutical Co., Daiichi Sankyo, Daiichi Sankyo; Dr. Hasegawa reported receiving grant from Boehringer Ingelheim., Pfizer Inc., Astellas Pharma Inc., ONO PHARMACEUTICAL CO., Shionogi & Co., AstraZeneca, Sanofi K.K., TEIJIN LIMITED, MSD K.K., Meiji Seika Pharma Co., DAIICHI SANKYO COMPANY, LIMITED., GlaxoSmithKline K.K., Otsuka Pharmaceutical Co., KYORIN Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Novartis Pharma K. K., Kyowa Hakko Kirin Co., Eli Lilly Japan K.K., Chugai Pharmaceutical Co. that was paid to Nagoya University.

    Ethical standards

    All procedures performed in studies were in accordance with the ethical standards of the Institutional Research Board and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

    Informed consent

    This study design was the retrospective observational cohort study with no invasiveness for patients. All data were obtained by reviewing medical charts. Therefore, informed consent for each patient was not required according to the Japanese guideline of cohort study. This study was approved by Ethics Committee of all institutions.

    Additional information

    Toshio Kato and Masahiro Morise have contributed equally to this article

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    Kato, T., Morise, M., Ando, M. et al. Can we predict the development of serious adverse events (SAEs) and early treatment termination in elderly non-small cell lung cancer (NSCLC) patients receiving platinum-based chemotherapy?. J Cancer Res Clin Oncol 142, 1629–1640 (2016). https://doi.org/10.1007/s00432-016-2170-z

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    • DOI: https://doi.org/10.1007/s00432-016-2170-z

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