Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials
2008

Chemotherapy for Elderly Patients with Malignant Pleural Mesothelioma

Sample size: 178 publication Evidence: moderate

Author Information

Author(s): Ceresoli G L, Castagneto B, Zucali P A, Favaretto A, Mencoboni M, Grossi F, Cortinovis D, Conte G Del, Ceribelli A, Bearz A, Salamina S, De Vincenzo F, Cappuzzo F, Marangolo M, Torri V, Santoro A

Primary Institution: Istituto Clinico Humanitas IRCCS, Rozzano, Milano, Italy

Hypothesis

Can pemetrexed plus carboplatin be an effective treatment for elderly patients with malignant pleural mesothelioma?

Conclusion

Pemetrexed and carboplatin are effective and well tolerated in elderly patients with malignant pleural mesothelioma.

Supporting Evidence

  • Elderly patients (≥70 years) represented 27% of the study population.
  • Grade 3–4 haematological toxicity was slightly worse in elderly patients.
  • Overall disease control rates were similar between elderly and younger patients.
  • Median time to progression was 7.2 months for elderly and 7.5 months for younger patients.
  • Median overall survival was 10.7 months for elderly and 13.9 months for younger patients.

Takeaway

This study shows that older patients can safely receive chemotherapy for lung cancer and get similar benefits as younger patients.

Methodology

Retrospective analysis of pooled data from two phase II trials comparing the efficacy and toxicity of pemetrexed and carboplatin in elderly versus younger patients.

Potential Biases

Potential selection bias as only fit elderly patients were included.

Limitations

The study may not represent the oldest patients (≥75 years) due to the small sample size in that group.

Participant Demographics

Median age was 65 years, with 27% of patients aged 70 years or older.

Statistical Information

P-Value

{"neutropenia":0.11,"anaemia":0.01,"overall_disease_control":0.47,"time_to_progression":0.42,"overall_survival":0.12}

Confidence Interval

{"elderly_response_rate":"95% CI: 6.1–27.8%","younger_response_rate":"95% CI: 16.8–32.1%","elderly_disease_control":"95% CI: 45.3–74.2%","younger_disease_control":"95% CI: 58.1–74.9%"}

Digital Object Identifier (DOI)

10.1038/sj.bjc.6604442

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