Comparison of Platinum-Based Chemotherapy in Patients Older and Younger than 70 Years An Analysis of Southwest Oncology Group Trials 9308 and 9509

Purpose: This retrospective analysis sought to investigate the safety, feasibility, and outcomes of platinum doublet therapy in patients aged 70 years or older with advanced non-small cell lung cancer compared with patients younger than 70 years who participated in two randomized phase III trials conducted by the Southwest Oncology Group. Patients and Methods: Outcomes and toxicity data from fit patients with stage IIIB or stage IV non-small cell lung cancer treated with cisplatin/vinorelbine and carboplatin/paclitaxel were pooled from Southwest Oncology Group trials 9308 (S9308) and 9509 (S9509) and compared with respect to age. Results: A total of 616 patients were available for efficacy analyses, of which 122 (20%) were aged 70 years or older. The median progression-free survival was 4 months in both age groups (p = 0.71), and response rates were similar. Overall survival was significantly higher in the younger patient cohort (median 9 months versus 7 months, p = 0.04). Individual parameters of toxicity were similar in both age groups. Conclusion: Although patients aged 70 years or older derived initial benefit from platinum-based therapy, survival was better in younger patients. Additional studies in this growing patient population are needed to develop treatment strategies that minimize toxicity and increase efficacy.