Time-to-Treatment-Failure and Related Outcomes Among 1000+ Advanced Non-Small Cell Lung Cancer Patients: Comparisons Between Older Versus Younger Patients (Alliance A151711).
Time-to-Treatment-Failure and Related Outcomes Among 1000+ Advanced Non-Small Cell Lung Cancer Patients: Comparisons Between Older Versus Younger Patients (Alliance A151711).
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DOI：
10.1016/j.jtho.2018.03.020
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Le-Rademacher JG
中科院分区：
文献类型：
--
作者：
Gajra A;Zemla TJ;Jatoi A;Feliciano JL;Wong ML;Chen H;Maggiore R;McMurray RP;Hurria A;Muss HB;Cohen HJ;Lafky J;Edelman MJ;Lilenbaum R;Le-Rademacher JG
治疗失败时间(TTF)是指从化疗开始到过早停止的时间间隔。我们根据年龄评估TTF。对晚期非小细胞肺癌的一线化疗试验(CALGB9730、30203和30801)进行了合并分析。对年龄在65岁以上和70岁以上的患者进行了TTF(主要终点)、早期停止化疗的原因、3级以上不良事件和总存活率的比较。1006例患者中，65岁以上者460例(46%)。145名老年患者(占该年龄组的32%)完成了所有六个计划的化疗周期，170名年轻患者(32%)也完成了计划的化疗周期。中位TTF在老年患者为2.9个月(95%可信区间=(2.7，3.2))，在年轻患者为3个月(95%可信区间=(2.9，3.5))；通过试验调整功能状态和化疗分层后，TTF在年龄上没有显著差异。然而，早期停止化疗的原因在不同年龄组之间不同(多变量p=0.004)。与年轻患者(分别为13%和6%)相比，年龄较大的患者停止癌症进展的可能性较小(41%对55%)，更有可能是由于毒性或患者选择(分别为16%和15%)。年龄较大的患者更有可能经历3级以上的不良事件(86%对79%)，在存活率方面没有统计学差异。年龄切点为70岁以上的患者在TTF方面没有差异，由于癌症进展而早期停止治疗的趋势较低，老年患者的生存期略有缩短。TTF在老年患者和年轻患者之间具有可比性；但不同的、基于年龄的和潜在的可修改的原因解释了这一点。
Time-to-treatment-failure (TTF) is the interval from chemotherapy initiation to premature discontinuation. We evaluated TTF based on age. Pooled analyses were conducted with, first-line chemotherapy trials for advanced non-small cell lung cancer (CALGB 9730, 30203, and 30801). Comparisons -- with age 65+ and 70+ years -- were performed for TTF (primary endpoint), reasons for early chemotherapy cessation, grade 3+ adverse events, and overall survival. Among 1006 patients, 460 (46%) were 65+ years of age. 145 older patients (32% of this age cohort) completed all six, planned chemotherapy cycles, as did 170 (32%) younger patients. Median TTF was 2.9 months (95% confidence interval (CI) = (2.7, 3.2)) in older and 3 months (95% CI= (2.9, 3.5)) in younger patients; adjustment for performance status and stratification by chemotherapy by trial yielded no statistically significant age-based difference in TTF. However, reasons for early chemotherapy cessation differed between age groups (multivariate p = 0.004). Older patients were less likely to discontinue from cancer progression (41% versus 55%) and more likely from toxicity or patient choice (16% and 15%, respectively) compared to younger patients (13% and 6%, respectively). Older patients were more likely to experience grade 3+ adverse events (86% versus 79%) with no statistically significant difference in survival. An age cut point of 70+ showed no difference in TTF, a lower trend of early cessation due to cancer progression, and somewhat shorter older patient survival. TTF was comparable between older and younger patients; but different, age-based, and potentially modifiable reasons account for it.
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影响因子：
3.1
作者：
Kim, Jin Won;Kim, Yu Jung;Kim, Jee Hyun
通讯作者：
Kim, Jee Hyun
影响因子：
45.3
作者：
Socinski, MA;Schell, MJ;Kies, MS
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Kies, MS
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作者：
Edelman, Martin J.;Wang, Xiaofei;Vokes, Everett E.
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Vokes, Everett E.
影响因子：
45.3
作者：
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作者：
Muss, Hyman;Cortes, Javier;O'Shaughnessy, Joyce
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O'Shaughnessy, Joyce