The Korean Journal of Medicine

  • 제87권5호
  • /
  • Pages.537-541
  • /
  • 2014
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

진행성 노인 폐암에 대한 항암요법

Anti-Cancer Therapy of Advanced Lung Cancer in Elderly Patients

  • 민영주 (울산대학교 의과대학 울산대학교병원 혈액종양내과)
  • Min, Young Joo (Division of Hematology-Oncology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 발행 : 2014.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Lung cancer is not only the most common cancer of the elderly but is also the leading cause of cancer-related mortality in Korea. Therefore, the elderly form a large subgroup of patients with advanced lung cancer. Aging is associated with co-morbidities, poor performance status, and impaired organ function. These problems can cause uncertainty when selecting the optimal treatment for advanced lung cancer, and some elderly patients could be undertreated. Patients with non-squamous histology lung cancer, regardless of age or performance status, should be tested for epidermal growth factor receptor (EGFR) mutations; patients with EGFR mutations such as del 19 or L858R are able to receive EGFR tyrosine kinase inhibitors. The treatment options for elderly patients with lung cancer include best supportive care, single agent chemotherapy, platinum-based doublet chemotherapy, and targeted therapy. The optimum therapeutic option for elderly individuals with advanced lung cancer must be selected carefully, taking into account both the risks and benefits.

키워드

참고문헌

  1. Pfister DG, Johnson DH, Azzoli CG, et al. American Society of Clinical Oncology treatment of unresectable non-small-cell lung cancer guideline: update 2003. J Clin Oncol 2004;22:330-353. https://doi.org/10.1200/JCO.2004.09.053
  2. Socinski MA, Crowell R, Hensing TE, et al. Treatment of non-small cell lung cancer, stage IV: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132(3 Suppl):277S-289S. https://doi.org/10.1378/chest.07-1381
  3. Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. The Elderly Lung Cancer Vinorelbine Italian Study Group. J Natl Cancer Inst 1999;91:66-72. https://doi.org/10.1093/jnci/91.1.66
  4. Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin- paclitaxel in pulmonary adenocarcinoma. N Engl J Med 2009;361:947-957. https://doi.org/10.1056/NEJMoa0810699
  5. Mitsudomi T, Morita S, Yatabe Y, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol 2010;11:121-128. https://doi.org/10.1016/S1470-2045(09)70364-X
  6. Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med 2010;362:2380-2388. https://doi.org/10.1056/NEJMoa0909530
  7. Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 2011;12:735-742. https://doi.org/10.1016/S1470-2045(11)70184-X
  8. Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-smallcell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 2012;13:239-246. https://doi.org/10.1016/S1470-2045(11)70393-X
  9. Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol 2013;31:3327-3334. https://doi.org/10.1200/JCO.2012.44.2806
  10. Wu YL, Zhou C, Hu CP, et al. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial. Lancet Oncol 2014;15:213-222. https://doi.org/10.1016/S1470-2045(13)70604-1
  11. Kubota K, Furuse K, Kawahara M, et al. Cisplatin-based combination chemotherapy for elderly patients with nonsmall- cell lung cancer. Cancer Chemother Pharmacol 1997;40:469-474. https://doi.org/10.1007/s002800050689
  12. Langer CJ, Manola J, Bernardo P, et al. Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial. J Natl Cancer Inst 2002;94:173-181. https://doi.org/10.1093/jnci/94.3.173
  13. Lilenbaum RC, Herndon JE, 2nd, List MA, et al. Singleagent versus combination chemotherapy in advanced nonsmall-cell lung cancer: the cancer and leukemia group B (study 9730). J Clin Oncol 2005;23:190-196. https://doi.org/10.1200/JCO.2005.07.172
  14. Hensing TA, Peterman AH, Schell MJ, Lee JH, Socinski MA. The impact of age on toxicity, response rate, quality of life, and survival in patients with advanced, Stage IIIB or IV nonsmall cell lung carcinoma treated with carboplatin and paclitaxel. Cancer 2003;98:779-788. https://doi.org/10.1002/cncr.11548
  15. Gridelli C, Perrone F, Gallo C, et al. Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian Lung Cancer in the Elderly Study (MILES) phase III randomized trial. J Natl Cancer Inst 2003;95:362-372. https://doi.org/10.1093/jnci/95.5.362
  16. Al-Saleh K, Quinton C, Ellis PM. Role of pemetrexed in advanced non-small-cell lung cancer: meta-analysis of randomized controlled trials, with histology subgroup analysis. Curr Oncol 2012;19:e9-e15.
  17. Li M, Zhang Q, Fu P, et al. Pemetrexed plus platinum as the first-line treatment option for advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials. PLoS One 2012;7:e37229. https://doi.org/10.1371/journal.pone.0037229
  18. Paz-Ares LG, de Marinis F, Dediu M, et al. PARAMOUNT: Final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol 2013;31:2895-2902. https://doi.org/10.1200/JCO.2012.47.1102
  19. Sundstrom S, Bremnes RM, Kaasa S, et al. Cisplatin and etoposide regimen is superior to cyclophosphamide, epirubicin, and vincristine regimen in small-cell lung cancer: results from a randomized phase III trial with 5 years' follow- up. J Clin Oncol 2002;20:4665-4672. https://doi.org/10.1200/JCO.2002.12.111
  20. Skarlos DV, Samantas E, Kosmidis P, et al. Randomized comparison of etoposide-cisplatin vs. etoposide-carboplatin and irradiation in small-cell lung cancer. A Hellenic Co-operative Oncology Group study. Ann Oncol 1994;5:601-607. https://doi.org/10.1093/oxfordjournals.annonc.a058931
  21. Okamoto H, Watanabe K, Kunikane H, et al. Randomised phase III trial of carboplatin plus etoposide vs split doses of cisplatin plus etoposide in elderly or poor-risk patients with extensive disease small-cell lung cancer: JCOG 9702. Br J Cancer 2007;97:162-169. https://doi.org/10.1038/sj.bjc.6603810
  22. Noda K, Nishiwaki Y, Kawahara M, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med 2002;346:85-91. https://doi.org/10.1056/NEJMoa003034
  23. Hanna N, Bunn PA, Jr., Langer C, et al. Randomized phase III trial comparing irinotecan/cisplatin with etoposide/cisplatin in patients with previously untreated extensive-stage disease small-cell lung cancer. J Clin Oncol 2006;24:2038-2043. https://doi.org/10.1200/JCO.2005.04.8595
  24. von Pawel J, Schiller JH, Shepherd FA, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol 1999;17:658-667. https://doi.org/10.1200/JCO.1999.17.2.658
  25. Eckardt JR, von Pawel J, Pujol JL, et al. Phase III study of oral compared with intravenous topotecan as second-line therapy in small-cell lung cancer. J Clin Oncol 2007;25:2086-2092. https://doi.org/10.1200/JCO.2006.08.3998