Skip Navigation LinksHome > August 2014 - Volume 9 - Issue 8 > Less Toxic Chemotherapy Improves Uptake of All Lines of Chem...
Journal of Thoracic Oncology:
doi: 10.1097/JTO.0000000000000225
Original Articles

Less Toxic Chemotherapy Improves Uptake of All Lines of Chemotherapy in Advanced Non–Small-Cell Lung Cancer: A 10-Year Retrospective Population-Based Review

Ho, Cheryl MD FRCPC*; Ramsden, Katherine BSc*; Zhai, Yongliang BSc; Murray, Nevin MD, FRCPC*; Sun, Sophie MD, FRCPC*; Melosky, Barbara MD, FRCPC*; Laskin, Janessa MD, FRCPC*

Collapse Box

Abstract

Background:

Over the past decade, well tolerated second-line therapies for advanced non–small-cell lung cancer have been approved including erlotinib and pemetrexed in addition to docetaxel. We hypothesize that the introduction of less toxic chemotherapy has increased treatment of advanced non–small-cell lung cancer resulting in improved survival.

Methods:

The BC Cancer Agency provides cancer care to 4.5 million. A retrospective review was conducted of all referred Stage IIIB/IV patients in four 1-year time cohorts; C1 baseline (1998) and 6 months after the provincial approval of C2 docetaxel (2001), C3 erlotinib (2006), and C4 pemetrexed (2007).

Results:

Two-thousand six-hundred and twenty-three patients were referred and 720 had systemic therapy. Characteristics: M/F 55%/45%, median age 67 (33–101), ECOG PS <=1/>=2/unknown 33%/56%/11%, squam/nonsquam/NOS 18%/41%/41%. More patients received first-line chemotherapy over time; 16%, 23%, 34%, and 33% C1–C4 respectively. In C1–C4 uptake of second line (21%, 27%, 37% and 55%) increased. Second-line docetaxel was frequently used in C2 (51%) but usage decreased in C4 to 7% versus erlotinib 50% and pemetrexed 26%. The median overall survival in the best supportive care group remained stable over time; however, increased use of systemic therapy was associated with improved survival C1 9.4 m versus C4 11.8 m (p = 0.023).

Conclusions:

This population-based data set represents the trend of treatments over time at community and tertiary care cancer treatment sites. Over a 10-year period an increased proportion of patients were treated with first-line chemotherapy and an even greater number with second-/third-line treatment with an associated improvement in overall survival.

Copyright © 2014 by the International Association for the Study of Lung Cancer

Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Other Ways to Connect

Twitter
twitter.com/JTOonline

 



Visit JTO.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.

 For additional oncology content, visit LWW Oncology Journals on Facebook.