The influence of sex and histology on outcomes in non-small-cell lung cancer: a pooled analysis of five randomized trials.
Authors
Wheatley-Price, PBlackhall, Fiona H
Lee, Siow Ming
Ma, C
Ashcroft, Linda
Jitlal, M
Qian, W
Hackshaw, A
Rudd, R
Booton, Richard
Danson, Sarah
Lorigan, Paul C
Thatcher, Nick
Shepherd, F A
Affiliation
Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada.Issue Date
2010-03-23
Metadata
Show full item recordAbstract
BACKGROUND: Some non-small-cell lung cancer (NSCLC) surgical series have indicated that the positive prognostic effect of female sex is limited to patients with adenocarcinoma. We carried out a retrospective analysis to investigate the role of sex and histology on efficacy, toxicity, and dose delivery after chemotherapy. Patient and methods: Individual patient data were pooled from five randomized, phase III, advanced NSCLC chemotherapy trials. Primary outcomes were response rate, overall survival (OS), toxicity, and dose delivery. A secondary analysis examined survival by sex in histological subgroups. RESULTS: Of 2349 patients, 34% were women. Women had a higher response rate to chemotherapy (42% versus 40%, P = 0.01) and longer survival than men (median OS 9.6 versus 8.6 months, P = 0.002). The difference in OS remained after adjusting for age, stage, performance status, and histology (hazard ratio 0.83, 95% confidence interval 0.74-0.92, P = 0.0005). Upon further examination, longer survival in women was only seen in patients with adenocarcinoma (test for interaction P = 0.006). There were no differences in hematological toxicity or transfusions. Women experienced more grade 3-4 emesis than men (P < 0.0001) and more dose delays (P = 0.02) or dose reductions (P < 0.0001). CONCLUSION: The positive prognostic effect among women is confirmed in patients receiving platinum-based chemotherapy but appears confined to those with adenocarcinoma histology.Citation
The influence of sex and histology on outcomes in non-small-cell lung cancer: a pooled analysis of five randomized trials. 2010:Ann OncolJournal
Annals of OncologyDOI
10.1093/annonc/mdq067PubMed ID
20332134Type
ArticleLanguage
enISSN
1569-8041ae974a485f413a2113503eed53cd6c53
10.1093/annonc/mdq067
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