Trends and predictors of first-line chemotherapy use among elderly patients with advanced non-small cell lung cancer in the United States

Kathleen Lang, Martin D. Marciniak, Doug Faries, Michael Stokes, Don Buesching, Craig Earle, Joseph Treat, Nathalie Morissette, David Thompson

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52 Scopus citations

Abstract

Purpose: This study assessed first-line chemotherapy treatment patterns over time and identified predictors of chemotherapy use and treatment selection among elderly patients with newly diagnosed Stage IIIB/IV non-small cell lung cancer (NSCLC) in the United States. Methods: Patients aged 65 years and older newly diagnosed with Stage IIIB/IV NSCLC between 1997 and 2002 were identified and followed through 2003 using the Surveillance, Epidemiology and End Results (SEER)-Medicare database to evaluate temporal trends in chemotherapy treatment. Multivariate logistic regression models were estimated to identify predictors of chemotherapy treatment and factors associated with use of cisplatin/carboplatin (platinum) and either a taxane or gemcitabine versus other treatments. Results: Chemotherapy use increased from approximately 28% of Stage IIIB/IV NSCLC patients diagnosed in 1997 to 36% of patients diagnosed in 2002. Doublet therapy was most commonly used as first-line therapy, received by 74% of chemotherapy-treated patients across all study years. Use of doublet therapy with platinum and either a taxane or gemcitabine also increased over time (with the largest increase for gemcitabine combinations from 0.3% in 1997 to 11.8% in 2002). Males were more likely than females to be treated with chemotherapy (odds ratios [95% CI]: 1.14 [1.06-1.22]), as were patients in the Northeast and South relative to patients in the West (1.24 [1.13-1.36] and 1.33 [1.20-1.47], respectively). Conclusion: Use of first-line chemotherapy treatment among elderly Stage IIIB/IV NSCLC patients is low, but appears to be increasing, with potential regional and gender differences in treatment. These findings are likely to be of interest to clinicians and policymakers.

Original languageEnglish
Pages (from-to)264-270
Number of pages7
JournalLung Cancer
Volume63
Issue number2
DOIs
StatePublished - Feb 2009

Keywords

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung/drug therapy
  • Female
  • Humans
  • Lung Neoplasms/drug therapy
  • Male
  • Retrospective Studies
  • SEER Program

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