Non-small cell lung cancer comprises the majority of all lung cancers—which is the leading cause of cancer death across the world. Patients older than age 70 make up a large portion of all patients with non-small cell lung cancer, yet these patients are under-represented in clinical trials for this disease.

• Non-Small-Cell Lung Cancer in Elderly Patients: A Discussion of Treatment Options: Despite the majority of lung cancer cases occurring in the geriatric population, very little research exists on how to tailor treatment to this group’s needs. This Journal of Clinical Oncology article reviews the current data on treating non-small cell lung cancer in older adults with chemotherapy, focusing on patients with metastatic lung cancer, post-surgery early stage lung cancer, and locally advanced inoperable lung cancer.
   
• Carboplatin and Weekly Paclitaxel Doublet Chemotherapy Compared With Monotherapy in Elderly Patients With Advanced Non-Small-Cell Lung Cancer: IFCT-0501 Randomised, Phase 3 Trial: In an effort to see if the standard treatment regimen for advanced non-small cell lung cancer would also benefit older adults, researchers compared a doublet regimen of carboplatin and paclitaxel with monotherapy. As detailed in this Lancet article, the trial found that the standard platinum-based doublet regimen benefited older adults with non-small cell lung cancer, however was associated with increased toxicities.
   
• Randomized Phase III Trial of Single-Agent Pemetrexed Versus Carboplatin and Pemetrexed in Patients With Advanced Non-Small-Cell Lung Cancer and Eastern Cooperative Oncology Group Performance Status of 2:This Journal of Clinical Oncology article details the phase III trial comparing pemetrexed with pemetrexed plus carboplatin in patients with advanced non-small cell lung cancer. The trial participants were randomly assigned to one of the regimens and then stratified into several subgroups, including those age 70 and older versus younger than age 70. The results showed that for all subgroups, combination pemetrexed and carboplatin increased survival.
   
• The ELVIS Trial: A Phase III Study of Single-Agent Vinorelbine as First-Line Treatment in Elderly Patients With Advanced Non-Small Cell Lung Cancer: Despite ending early due to recruitment issues, this trial comparing best supportive care alone with best supportive care plus vinorelbine in patients age 70 and older with stage IIIB/V non-small cell lung cancer produced positive results. Not only did patients in the experimental arm have an increased survival compared with the control group, they also enjoyed better quality of life related to their disease symptoms and overall functioning, as detailed in this article in The Oncologist.
   
• Adjuvant Chemotherapy For Elderly Patients With Stage I Non-Small-Cell Lung Cancer >/=4 cm in Size: An SEER-Medicare Analysis: Researchers studied SEER-Medicare database data from more than 3,200 patients to shed light on the area of adjuvant chemotherapy for older patients with early-stage non-small cell lung cancer. The adjuvant treatments the team studied included platinum-based chemotherapy, post-operative radiation with or without chemotherapy, and resection only. The results of their analysis in this Annals of Oncology article show that this patient population benefits most from platinum-based adjuvant chemotherapy, which is associated with reduced mortality but increased serious adverse events.
   
• Medical Treatment of Advanced Non-Small-Cell Lung Cancer in Elderly Patients: A Review of the Role of Chemotherapy and Targeted Agents: This Journal of Geriatric Oncology article details findings from a literature review of studies treating older patients with advanced non-small cell lung cancer. The researchers focused on single-agent and doublet chemotherapy and targeted agents, and based on their findings, they note their treatment recommendations for different subgroups of older patients with this disease.
   
• ESOGIA:  Use of Comprehensive Geriatric Assessment for Management of Elderly Patients with Advanced Non-Small-Cell Lung Cancer: This is the first trial in metastatic NSCLC utilizing a geriatric assessment compared to “traditional” assessment measures such as age and ECOG PS to risk-stratify doublet chemotherapy vs. singlet chemotherapy vs. best supportive care.  Although time to treatment failure and survival were not improved with the GA-based strategy, fewer adverse events from chemotherapy toxicity were observed.