Clinical factors associated with treatment toxicity of pemetrexed plus platinum in elderly patients with non-small cell lung cancer
Journal
Journal of the Formosan Medical Association
Date Issued
2020
Author(s)
Abstract
Background: This study was to explore the clinical factors associated with treatment toxicities of pemetrexed plus platinum in elderly patients with non-small cell lung cancer (NSCLC). Methods: Chemo-naive patients aged ? 70 with advanced NSCLC treated with pemetrexed plus platinum were included. Medical records were reviewed and clinical data, including age, gender, smoking status, comorbidities, EGFR mutation status, chemotherapy regimens, previous use of epidermal growth factor receptor-tyrosine kinase inhibitors, treatment-related hematologic, renal, and hepatic toxicities, and treatment responses, were analyzed. Comorbidity conditions were evaluated by using the Simplified Comorbidity Score (SCS) and Charlson Comorbidity Index Score (CCIS). Results: A total of 144 patients were included. In the univariate analysis, patients with SCS >9 (p = 0.006) and cigarette smoking (p = 0.028) were associated with a significantly higher rate of grade 3/4 neutropenia than their counterpart. Carboplatin use was associated with a higher rate of grade 3/4 thrombocytopenia than cisplatin use (p = 0.028). In the multivariate analysis, SCS >9 was associated with a significantly higher risk of anemia of any grade (odds ratio [OR]: 2.72, 95% confidence interval [CI]: 1.09–6.77). Carboplatin use was associated a higher risk of any grade (OR: 4.61, 95% CI: 1.07–19.90) and grade 3/4 thrombocytopenia (OR: 7.37, 95% CI: 1.36–39.92). No clinical factors were found to be associated with hepatic and renal toxicities. Conclusion: High SCS and carboplatin use were associated with hematological toxicities with pemetrexed plus platinum use in elderly patients with NSCLC. ? 2019 Formosan Medical Association
SDGs
Other Subjects
carboplatin; cisplatin; pemetrexed; antineoplastic agent; pemetrexed; platinum; adult; aged; anemia; Article; Charlson Comorbidity Index; cigarette smoking; clinical practice; comorbidity; computer assisted tomography; creatinine clearance; current smoker; exon; female; human; major clinical study; male; multiple cycle treatment; nephrotoxicity; neutropenia; non small cell lung cancer; retrospective study; thrombocytopenia; treatment duration; treatment response; very elderly; lung tumor; treatment outcome; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Pemetrexed; Platinum; Treatment Outcome
Publisher
Elsevier B.V.
Type
journal article