Chemotherapy for advanced non-small cell lung cancer patients with performance status 2.
AffiliationDepartment of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK. Fiona.Blackhall@christie-tr.nwest.nhs.uk
MetadataShow full item record
AbstractPURPOSE OF REVIEW: A beneficial role for palliative chemotherapy in patients with advanced non-small cell lung cancer and a good performance status (ECOG 0 or 1) is now well established. In this article, we focus on the available literature for patients with a PS of 2, in whom a role for chemotherapy has yet to be defined. RECENT FINDINGS: In the past, the results of randomized trials of comparative standard platinum-based combination chemotherapy regimens have demonstrated inferior survival rates in PS 2 patients compared with those with PS 0 or 1. Consequently, a general view has emerged that the side effects of treatment outweigh the benefits, and chemotherapy has not been recommended as a standard of care. Although few studies have been designed specifically for PS 2 patients, gemcitabine, vinorelbine or taxane monotherapy, dose-attenuated platinum combination regimens, and epidermal growth factor receptor inhibitors may provide a clinical benefit with less toxicity. For example, although the median survival of PS 2 patients treated with best supportive care is 2-3 months, chemotherapy regimens are associated with median survivals ranging from 4 to 6 months. These data provide encouragement to revisit the role of chemotherapy in this group of patients. SUMMARY: There is potential with cytotoxic treatment to improve the palliative options for PS 2 patients with advanced non-small cell lung cancer. Further trials designed specifically for PS 2 patients that include measurement of symptoms, quality of life, and survival and toxicity are required to define the most active but least toxic regimens.
CitationChemotherapy for advanced non-small cell lung cancer patients with performance status 2. 2005, 17 (2):135-9 Curr Opin Oncol
JournalCurrent Opinion in Oncology
- Treatment of locally advanced non-small cell lung cancer in the elderly.
- Authors: Gridelli C, Maione P, Rossi A, Ciardiello F, Raben D
- Issue date: 2005 Mar
- Improving survival and reducing toxicity with chemotherapy in advanced non-small cell lung cancer : a realistic goal?
- Authors: Blackhall FH, Shepherd FA, Albain KS
- Issue date: 2005
- Treatment of advanced non-small-cell lung cancer in the elderly: results of an international expert panel.
- Authors: Gridelli C, Aapro M, Ardizzoni A, Balducci L, De Marinis F, Kelly K, Le Chevalier T, Manegold C, Perrone F, Rosell R, Shepherd F, De Petris L, Di Maio M, Langer C
- Issue date: 2005 May 1
- Sequential, alternating, and maintenance/consolidation chemotherapy in advanced non-small cell lung cancer: a review of the literature.
- Authors: Grossi F, Aita M, Follador A, Defferrari C, Brianti A, Sinaccio G, Belvedere O
- Issue date: 2007 Apr
- Targeted therapies and non-small cell lung cancer: methodological and conceptual challenge for clinical trials.
- Authors: Perrone F, Di Maio M, Budillon A, Normanno N
- Issue date: 2005 Mar