***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to assess whether a combination of gemcitabine ( GEM ) with either paclitaxel ( PTX ) or vinorelbine ( VNR ) could be more effective than GEM or PTX alone in elderly or unfit advanced non-small-cell lung cancer ( NSCLC ) patients . A total of 264 NSCLC patients aged > 70 years with ECOG performance status (PS)⩽2 , or younger with PS=2 , were r and omly treated with : GEM 1200 mg m−2 on days 1 , 8 and 15 every 28 days ; PTX 100 mg m−2 on days 1 , 8 and 15 every 28 days ; GEM 1000 mg m−2 plus PTX 80 mg m−2 ( GT ) on days 1 and 8 every 21 days ; GEM 1000 mg m−2 plus VNR 25 mg m−2 ( GV ) on days 1 and 8 every 21 days . In all arms , an intra- patients dose escalation was applied over the first three courses , provided that no toxicity of WHO grade ⩾2 had previously occurred . At present time , 217 ( 82 % ) patients had died . The median ( months ) and 1-year survival probability were 5.1 and 29 % for GEM , 6.4 and 25 % for PTX , 9.2 and 44 % for GT , and 9.7 and 32 % for GV . Multivariate analysis showed that PS⩽1 ( hazard ratio (HR)=0.67 ; 95 % CI 0.51–0.90 ) , and doublet treatments ( HR=0.76 ; 95 % CI 0.59–0.99 ) were significantly associated with longer survival . Doublets produced no more toxicity than single agents . GT should be considered a reference regimen for elderly NSCLC patients with PS⩽1 The optimal treatment strategy for elderly patients with advanced nonsmall cell lung carcinoma has not been defined to date . The authors performed a retrospective analysis of a Phase III trial that treated patients who had Stage IIIB or IV nonsmall cell lung carcinoma with carboplatin and paclitaxel and analyzed the impact of age on response rate , survival , toxicity , and quality of life The aim of this study was to compare the efficacy of single‐agent weekly docetaxel with the combination of docetaxel and gemcitabine in elderly and /or poor performance status patients with advanced nonsmall cell lung cancer ( NSCLC ) BACKGROUND Platinum-based doublet chemotherapy is recommended to treat advanced non-small-cell lung cancer ( NSCLC ) in fit , non-elderly adults , but monotherapy is recommended for patients older than 70 years . We compared a carboplatin and paclitaxel doublet chemotherapy regimen with monotherapy in elderly patients with advanced NSCLC . METHODS In this multicentre , open-label , phase 3 , r and omised trial we recruited patients aged 70 - 89 years with locally advanced or metastatic NSCLC and WHO performance status scores of 0 - 2 . Patients received either four cycles ( 3 weeks on treatment , 1 week off treatment ) of carboplatin ( on day 1 ) plus paclitaxel ( on days 1 , 8 , and 15 ) or five cycles ( 2 weeks on treatment , 1 week off treatment ) of vinorelbine or gemcitabine monotherapy . R and omisation was done central ly with the minimisation method . The primary endpoint was overall survival , and analysis was done by intention to treat . This trial is registered , number NCT00298415 . FINDINGS 451 patients were enrolled . 226 were r and omly assigned  monotherapy  and 225  doublet chemotherapy .  Median age was 77 years and median follow-up was 30.3 months ( range 8.6 - 45.2 ) . Median overall survival was 10.3 months for doublet chemotherapy and 6.2 months for monotherapy ( hazard ratio 0.64 , 95 % CI 0.52 - 0.78 ; p<0.0001 ) ; 1-year survival was 44.5 % ( 95 % CI 37.9 - 50.9 ) and 25.4 % ( 19.9 - 31.3 ) , respectively . Toxic effects were more frequent in the doublet chemotherapy group than in the monotherapy group ( most frequent , decreased neutrophil count ( 108 [ 48.4 % ] vs 28 [ 12.4 % ] ; asthenia 23 [ 10.3 % ] vs 13 [ 5.8 % ] ) . INTERPRETATION Despite increased toxic effects , platinum-based doublet chemotherapy was associated with survival benefits compared with vinorelbine or gemcitabine monotherapy in elderly patients with NSCLC . We feel that the current treatment paradigm for these patients should be reconsidered . FUNDING Intergroupe Francophone de Cancérologie Thoracique , Institut National du Cancer BACKGROUND Vinorelbine prolongs survival and improves quality of life in elderly patients with advanced non-small-cell lung cancer ( NSCLC ) . Some studies have also suggested that gemcitabine is well tolerated and effective in such patients . We compared the effectiveness and toxicity of the combination of vinorelbine plus gemcitabine with those of each drug given alone in an open-label , r and omized phase III trial in elderly patients with advanced NSCLC . METHODS Patients aged 70 years and older , enrolled between December 1997 and November 2000 , were r and omly assigned to receive intravenous vinorelbine ( 30 mg/m(2 ) of body surface area ) , gemcitabine ( 1200 mg/m(2 ) ) , or vinorelbine ( 25 mg/m(2 ) ) plus gemcitabine ( 1000 mg/m(2 ) ) . All treatments were delivered on days 1 and 8 every 3 weeks for a maximum of six cycles . The primary endpoint was survival . Survival curves were drawn using the Kaplan-Meier method and analyzed by the Mantel-Haenszel test . Secondary endpoints were quality of life and toxicity . RESULTS Of 698 patients available for intention-to-treat analysis , 233 were assigned to receive vinorelbine , 233 to gemcitabine , and 232 to vinorelbine plus gemcitabine . Compared with each single drug , the combination treatment did not improve survival . The hazard ratio of death for patients receiving the combination treatment was 1.17 ( 95 % confidence interval [ CI ] = 0.95 to 1.44 ) that of patients receiving vinorelbine and 1.06 ( 95 % CI = 0.86 to 1.29 ) that of patients receiving gemcitabine . Although quality of life was similar across the three treatment arms , the combination treatment was more toxic than the two drugs given singly . CONCLUSION The combination of vinorelbine plus gemcitabine is not more effective than single-agent vinorelbine or gemcitabine in the treatment of elderly patients with advanced NSCLC BACKGROUND Older patients , even if fit , are often considered incapable of tolerating platinum-based systemic therapy . We performed a retrospective analysis of Eastern Cooperative Oncology Group ( ECOG ) 5592 , a phase III r and omized trial of platinum-based chemotherapy regimens for non-small-cell lung cancer ( NSCLC ) , and compared outcomes in enrollees 70 years of age and older with those in younger patients . METHODS ECOG carried out a r and omized phase III trial of cisplatin plus either etoposide or paclitaxel in chemotherapy-naïve NSCLC patients with stages III(B ) or IV disease .  Toxic effects , response rates , and survival rates were compared between age groups . All P values were two-sided . RESULTS A total of 574 patients enrolled from August 1993 through December 1994 were evaluable . Eighty-six ( 15 % ) were 70 years old or older . Older patients had a higher incidence of cardiovascular ( P = .009 ) and respiratory ( P = .04 ) comorbidities and nonanalgesic medication use ( P = .02 ) . Leukopenia ( P<.001 ) and neuropsychiatric toxicity ( P = .002 ) were more common in elderly men than in younger men . Elderly women lost more weight than younger women ( P = .006 ) . Other toxic effects were similar in older and younger patients . The proportions with clinical partial or complete response ( 21.5 % versus 23.3 % ; Fisher 's exact test , P = .66 ) , median time to progression ( 4.37 versus 4.30 months ; log-rank test , P = .29 ) , and survival distribution ( log-rank test , P = .29 ; median survival , 9.05 versus 8.53 months ; 1-year survival , 38 % versus 29 % ; and 2-year survival , 14 % versus 12 % ) were similar in patients younger than 70 years and 70 years old or older . Baseline quality -of-life and treatment- outcome indices were similar . Equivalent declines over time in functional well-being occurred in both groups . CONCLUSION Response rate , toxicity , and survival in fit , elderly NSCLC patients receiving platinum-based treatment appear to be similar to those in younger patients , although patients 70 years old or older have more comorbidities and can expect more leukopenia and neuropsychiatric toxicity . Advanced age alone should not preclude appropriate NSCLC treatment Controversy continues over whether elderly patients with advanced nonsmall cell lung carcinoma ( NSCLC ) should receive platinum‐based chemotherapy . TAX 326 reported improved survival with docetaxel – cisplatin ( DC ) versus vinorelbine – cisplatin ( VC ) for advanced NSCLC . DC and docetaxel – carboplatin ( DCb ) were better tolerated  than VC . We analyzed the efficacy and toxicity in patients ages < 65 and ≥ 65 years OBJECTIVE This phase III study was aim ed at evaluating whether the addition of gemcitabine ( G ) to vinorelbine ( V ) could improve the survival and quality of life ( QoL ) of elderly patients with advanced NSCLC . PATIENTS AND METHODS Patients with advanced NSCLC , aged > or=70 years , were r and omly allocated to receive V 30 mg/m(2 ) on days 1 and 8 every 3 weeks or G 1200 mg/m(2 ) plus V 30 mg/m(2 ) on days 1 and 8 every 3 weeks . Survival was the main end point of the study . The estimated sample size was 120 patients per arm , but an interim analysis of survival was planned on the first 60 patients per arm . RESULTS In May 1999 , an interim analysis was performed with the survival data of the first 120 eligible patients ( V(arm)=60 , G+V(arm)=60 ) . Forty-nine patients had stage IIIB disease and 71 patients stage IV disease , median potential follow-up of 14 months ( range ; 3 - 22 ) , 93 patients had died ( G+V(arm)=41 , V(arm)=52 ) . Median survival time ( MST ) was 29 weeks and projected 1-year survival was 30 % in the G+V(arm ) ; these values were 18 weeks and 13 % in the V(arm ) . At multivariate Cox analysis , the risk of death in the G+V(arm ) compared with V(arm ) was 0.48 ( 95 % C1=0.29 - 0.79 ; P<0.01 ) . Combination therapy was also associated with a clear delay in symptom and QoL deterioration . The ORR was 22 and 15 % in the G+V and V(arms ) , respectively . Toxicity was not irrelevant in both arms . CONCLUSIONS G+V treatment is associated with a significantly better survival than V alone in elderly NSCLC patients . The magnitude of the difference justifies the early closure of the study . The G+V regimen is now the SICOG reference regimen in this type of patients 7509 Background : Tri-weekly D is one of the st and ard treatment regimens for elderly advanced NSCLC pts . To investigate whether the addition of a modified platinum agent might improve the survival in these patients , we conducted a phase III trial comparing weekly DP with tri-weekly D. METHODS Eligibility criteria were : chemotherapy-naïve ; unfit for bolus P administration ; stage III/IV or relapsed NSCLC ; age≥70 ; PS 0 - 1 . Pts were r and omized to receive either DP or D by the minimization method , balancing for site , age ( < 75/≥75 ) , and stage ( III/IV ) .  DP comprised administration of D ( 20 mg/m2 ) and P ( 25 mg/m2 ) iv on days 1 , 8 , and 15 every 4 weeks . D comprised administration of D ( 60 mg/m2 ) iv on day 1 every 3 weeks . The primary endpoint was overall survival ( OS ) . The planned sample size was 190 pts in each arm , to provide an 80 % power to detect a 0.752 hazard ratio for DP to D in regard to the OS , and a 5 % one-sided alpha . RESULTS Between Oct 2008 and Sep 2010 , 276 pts were r and omized ( D/DP : 137/139 ) . The first planned interim analysis was performed on 22 
    Output:
    
Conclusions Our results indicated that doublet therapy was superior to a single third-generation cytotoxic agent for elderly patients with advanced NSCLC .