Second-Line Therapy for Elderly Patients with Non-small Cell Lung Cancer Who Failed Previous Chemotherapy Is as Effective as for Younger Patients

Introduction: It was found that second-line or thereafter therapies for patients with non-small cell lung cancer (NSCLC) who failed previous chemotherapy yielded a modest survival benefit. However, whether elderly patients (>= 70 years) benefit and are as suitable for salvage therapy as nonelderly patients (< 70 years) are unknown. Whether epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is more favorable than chemotherapeutic agents as a salvage therapy agent in elderly patients with NSCLC is also undetermined. Methods: We retrospectively reviewed and updated the data of our patients with NSCLC who received second-line salvage therapies, classified them into elderly and nonelderly groups, and compared the efficacy, toxicities, and survival of the patients. Results: Four hundred sixty-one cases were reviewed. The nonelderly group had a similar response rate, control rate, and median survival time than the elderly group (p = 0.2, p = 0.9, and p = 0.5, respectively). The median progression-free time was numerically longer in the elderly than the nonelderly patients (p = 0.08). The nonelderly group had statistically insignificantly less hematologic toxicities than the elderly group, but more nausea and vomiting. In addition, the use of EGFR-TKI salvage therapy, compared with salvage chemotherapies in the elderly group, resulted in a similar disease control rate and median survival time and more favorable toxicity profiles. Conclusions: There were no differences in the efficacy of salvage chemotherapies and EGFR-TKI therapy, in terms of response rate, control rate, and overall survival, in elderly and nonelderly patients, and the therapies had acceptable toxicities. Age itself should not preclude patients with NSCLC from second-line salvage therapy.