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First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data

Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In...

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Autores principales: Noda-Narita, Shoko, Kawachi, Asuka, Okuyama, Ayako, Sadachi, Ryo, Hirakawa, Akihiro, Goto, Yasushi, Fujiwara, Yasuhiro, Higashi, Takahiro, Yonemori, Kan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452055/
https://www.ncbi.nlm.nih.gov/pubmed/34543332
http://dx.doi.org/10.1371/journal.pone.0257489
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author Noda-Narita, Shoko
Kawachi, Asuka
Okuyama, Ayako
Sadachi, Ryo
Hirakawa, Akihiro
Goto, Yasushi
Fujiwara, Yasuhiro
Higashi, Takahiro
Yonemori, Kan
author_facet Noda-Narita, Shoko
Kawachi, Asuka
Okuyama, Ayako
Sadachi, Ryo
Hirakawa, Akihiro
Goto, Yasushi
Fujiwara, Yasuhiro
Higashi, Takahiro
Yonemori, Kan
author_sort Noda-Narita, Shoko
collection PubMed
description Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In clinical practice, physicians are required to decide the treatment based on a lack of enough evidence. This study aimed to examine the prescribing patterns of first-line chemotherapy according to age in the real-world practice. Data from the survey database of Diagnostic Procedure Combination and hospital-based cancer registries of designated cancer centers nationwide were used. The first-line chemotherapy regimens among 9,737 patients who were diagnosed with advanced lung cancer between January and December 2013, were identified and compared based on age. We found that the proportion of patients receiving chemotherapy decreased with age; 80.0%, 70.4%, 50.6%, and 30.2% of patients aged 70–74, 75–79, 80–84, and ≥ 85 years, respectively, received chemotherapy. Among them, platinum doublets were prescribed for 62.7% of the patients who were aged ≥ 70 years, and 60.7% of the patients who were aged ≥ 75 years with no driver mutations in NSCLC; only 37.6% of them received single agents. Patients who were aged ≥ 80 years also preferred platinum doublets (35.6%). Carboplatin was commonly prescribed in all age groups; only 28.4% of those receiving platinum doublets selected cisplatin. In this study, platinum doublets were identified as the most commonly prescribed regimen in those who were aged ≥ 70 years. Despite recommendations of Japanese guidelines for NSCLC, 60.7% of those who were aged ≥75 years received platinum doublets. Additionally, patients who were aged ≥ 80 years also received systemic chemotherapy, including platinum doublets; age did not solely influence regimen selection.
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spelling pubmed-84520552021-09-21 First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data Noda-Narita, Shoko Kawachi, Asuka Okuyama, Ayako Sadachi, Ryo Hirakawa, Akihiro Goto, Yasushi Fujiwara, Yasuhiro Higashi, Takahiro Yonemori, Kan PLoS One Research Article Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In clinical practice, physicians are required to decide the treatment based on a lack of enough evidence. This study aimed to examine the prescribing patterns of first-line chemotherapy according to age in the real-world practice. Data from the survey database of Diagnostic Procedure Combination and hospital-based cancer registries of designated cancer centers nationwide were used. The first-line chemotherapy regimens among 9,737 patients who were diagnosed with advanced lung cancer between January and December 2013, were identified and compared based on age. We found that the proportion of patients receiving chemotherapy decreased with age; 80.0%, 70.4%, 50.6%, and 30.2% of patients aged 70–74, 75–79, 80–84, and ≥ 85 years, respectively, received chemotherapy. Among them, platinum doublets were prescribed for 62.7% of the patients who were aged ≥ 70 years, and 60.7% of the patients who were aged ≥ 75 years with no driver mutations in NSCLC; only 37.6% of them received single agents. Patients who were aged ≥ 80 years also preferred platinum doublets (35.6%). Carboplatin was commonly prescribed in all age groups; only 28.4% of those receiving platinum doublets selected cisplatin. In this study, platinum doublets were identified as the most commonly prescribed regimen in those who were aged ≥ 70 years. Despite recommendations of Japanese guidelines for NSCLC, 60.7% of those who were aged ≥75 years received platinum doublets. Additionally, patients who were aged ≥ 80 years also received systemic chemotherapy, including platinum doublets; age did not solely influence regimen selection. Public Library of Science 2021-09-20 /pmc/articles/PMC8452055/ /pubmed/34543332 http://dx.doi.org/10.1371/journal.pone.0257489 Text en © 2021 Noda-Narita et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Noda-Narita, Shoko
Kawachi, Asuka
Okuyama, Ayako
Sadachi, Ryo
Hirakawa, Akihiro
Goto, Yasushi
Fujiwara, Yasuhiro
Higashi, Takahiro
Yonemori, Kan
First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title_full First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title_fullStr First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title_full_unstemmed First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title_short First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data
title_sort first-line treatment for lung cancer among japanese older patients: a real-world analysis of hospital-based cancer registry data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452055/
https://www.ncbi.nlm.nih.gov/pubmed/34543332
http://dx.doi.org/10.1371/journal.pone.0257489
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