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    The influence of sex and histology on outcomes in non-small-cell lung cancer: a pooled analysis of five randomized trials.

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    Authors
    Wheatley-Price, P
    Blackhall, 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
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    Affiliation
    Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada.
    Issue Date
    2010-03-23
    
    Metadata
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    Abstract
    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 Oncol
    Journal
    Annals of Oncology
    URI
    http://hdl.handle.net/10541/107554
    DOI
    10.1093/annonc/mdq067
    PubMed ID
    20332134
    Type
    Article
    Language
    en
    ISSN
    1569-8041
    ae974a485f413a2113503eed53cd6c53
    10.1093/annonc/mdq067
    Scopus Count
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    All Christie Publications

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