Treatment of advanced non-small-cell lung cancer patients with ECOG performance status 2: results of an European Experts Panel
Open Access
- 1 March 2004
- journal article
- research article
- Published by Elsevier in Annals of Oncology
- Vol. 15 (3) , 419-426
- https://doi.org/10.1093/annonc/mdh087
Abstract
Background: Platinum-based combination chemotherapy is currently recommended as the standard treatment for patients with advanced non-small-cell lung cancer (NSCLC), but its benefit seems limited to fit patients with a performance status (PS) of 0 or 1. For PS2 patients, there is no consensus on standard treatment. With the aims of reviewing the evidence supporting each of these therapeutic options, possibly reaching a consensus for treatment of PS2 patients affected by advanced NSCLC in clinical practice, and suggesting the priorities for clinical research in this field, an European Experts Panel took place in Avellino, Italy in April 2003. Results and conclusions On the basis of current evidence, chemotherapy treatment appears justified for patients with advanced NSCLC and PS2. Single-agent chemotherapy (gemcitabine, vinorelbine, taxanes) could be the preferred option, although carboplatin-based or low-dose cisplatin-based doublets may represent alternative options. Stronger evidence is expected from new clinical research specifically focused on PS2 patients. Single-agent chemotherapy should be the standard arm against which experimental treatments are tested in randomised trials dedicated to PS2 patients. High priority should be given to the evaluation of tolerability and efficacy of platinum-based combinations, and to the testing of new biological agents. Another research priority is the improvement of supportive care. Patients strongly need symptomatic improvement: end points such as symptom relief, clinical benefit and quality of life should have a central position in trials dedicated to PS2 NSCLC patients.Keywords
This publication has 35 references indexed in Scilit:
- Cisplatin Plus Gemcitabine Versus a Cisplatin-Based Triplet Versus Nonplatinum Sequential Doublets in Advanced Non–Small-Cell Lung Cancer: A Spanish Lung Cancer Group Phase III Randomized TrialJournal of Clinical Oncology, 2003
- Gemcitabine Plus Vinorelbine Compared With Cisplatin Plus Vinorelbine or Cisplatin Plus Gemcitabine for Advanced Non–Small-Cell Lung Cancer: A Phase III Trial of the Italian GEMVIN Investigators and the National Cancer Institute of Canada Clinical Trials GroupJournal of Clinical Oncology, 2003
- Multi-Institutional Randomized Phase II Trial of Gefitinib for Previously Treated Patients With Advanced Non–Small-Cell Lung CancerJournal of Clinical Oncology, 2003
- Global cancer statistics in the year 2000The Lancet Oncology, 2001
- Platinum-based and non-platinum-based chemotherapy in advanced non-small-cell lung cancer: a randomised multicentre trialThe Lancet, 2001
- Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment TrialsNew England Journal of Medicine, 1999
- Prognostic Factors for Short-term Survival in Patients with Stage IV Non-small Cell Lung CancerJapanese Journal of Cancer Research, 1999
- Prognostic factors for patients with advanced non-small cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamationLung Cancer, 1996
- Karnofsky and ECOG performance status scoring in lung cancer: A prospective, longitudinal study of 536 patients from a single institutionEuropean Journal Of Cancer, 1996
- Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public.BMJ, 1990