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Vol.55 No.6 contents | Japanese/English |
 | Full Text of PDF (812K) Article in Japanese |
- Review Article -
Chemotherapy for Elderly Patients with Lung Cancer
Hiroaki Okamoto11Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Japan
In Japan, the number of elderly patients with lung cancer is increasing along with the prolongation of life. In the 2012 Japan cancer registry, 73% of lung cancer deaths occurred in patients ≥ 70 years of age. The Japanese guidelines recommend monotherapy with third-generation agents as grade A treatment and carboplatin-based doublets as grade C1 treatment for elderly patients with an epidermal growth factor receptor (EGFR) wild-type status or unknown advanced non-squamous non-small cell lung cancer (NSCLC) and recommend the same regimen for elderly patients with advanced squamous cell lung cancer. However, three meta-analyses reported conflicting results regarding the use of monotherapy vs. doublet chemotherapy in elderly patients with advanced NSCLC. Therefore, no clear-cut consensus for optimal chemotherapy for this population exists. In Japan, a phase III trial evaluating the inferiority of carboplatin-pemetrexed doublet chemotherapy to docetaxel monotherapy is ongoing among elderly patients with advanced non-squamous NSCLC. Although no comparative trials in elderly patients with EGFR mutation-positive disease have been reported, the use of EGFR tyrosine kinase inhibitors (TKIs) in this population has been widely accepted based on several phase II trials in Japan. A Japan Clinical Oncology Group (JCOG) phase III trial demonstrated the superiority of daily carboplatin plus thoracic radiotherapy over radiotherapy alone for elderly patients with locally advanced stage III NSCLC. In elderly patients with extensive disease small cell lung cancer (ED-SCLC), carboplatin plus etoposide (CE) is considered to be a standard regimen, and a JCOG phase II/III study comparing carboplatin plus irinotecan with CE for elderly patients with ED-SCLC is ongoing. Although the use of a simple and effective comprehensive geriatric assessment (CGA) has been warranted for a long time, no standard CGA methods have been established to date. Additional clinical trials of elderly lung cancer patients are thus needed.
key words: Elderly, Chemotherapy, Small cell lung cancer (SCLC), Non-small cell lung cancer (NSCLC), Comprehensive geriatric assessment (CGA)
JJLC 55 (6): 889-899, 2015
