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The Role of the Taxanes in the Treatment of Older Patients with Advanced Stage Non-Small Cell Lung Cancer

Department of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA

Key Words. Carcinoma • Non-small cell lung • Aged • Elderly • Docetaxel • Paclitaxel • Taxoids

Correspondence: Correspondence: Suresh S. Ramalingam, M.D., Emory Winship Cancer Institute, 1365 Clifton Road NE, Atlanta, Georgia 30322, USA. Telephone: 404-778-5961; Fax: 404-778- 5550; e-mail: suresh.ramalingam{at}emory.edu

Received August 22, 2008; accepted for publication February 28, 2009.

Disclosures: Suresh S. Ramalingam: None; Fadlo R. Khuri: Consultant/advisory role: Sanofi-Aventis; Honoraria: Sanofi-Aventis. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

The treatment of older patients with advanced non-small cell lung cancer (NSCLC) represents a considerable challenge for physicians. A patient's suitability for chemotherapy is frequently based solely on chronologic age; as a consequence, older patients with NSCLC are less likely to receive standard chemotherapy than younger patients. Although age-related factors, such as comorbid illness, should be taken into consideration when assessing a patient's suitability for treatment, fit and functionally independent older patients should be considered candidates for standard chemotherapy. The taxanes are widely used in the treatment of advanced-stage NSCLC and are well tolerated in older patients. The efficacy of both paclitaxel and docetaxel has been studied in older patients and appears to be comparable with that seen in younger patients either as monotherapy or in combination with a platinum compound as first-line therapy. In addition to the available evidence, prospective evaluation of novel agents in elderly-specific or -enriched studies is necessary to guide the treatment of older patients with NSCLC.