A Retrospective Evaluation of Chemotherapy Regimens in Unselected Patients with Metastatic Non-Small Cell Lung Cancer

Background: Randomized clinical trials have demonstrated the benefits of chemotherapy in carefully selected non-small cell lung cancer (NSCLC) patients. How generalizable these results are to other NSCLC patients is unresolved. Methods: The outcomes of patients treated with standard chemotherapy regimens (paclitaxel / carboplatin; gemcitabine / carboplatin; pemetrexed / carboplatin; paclitaxel / carboplatin / bevacizumab) off study as first line therapy between 2002 and 2012 at our institution were compared to the reported results of trials supporting the FDA approval of these drugs and/or regimens. Results: In our population, 38.1% of the patients had hypertension, 11.9% of the patients were diabetic, 23.7% had chronic obstructive pulmonary disease (COPD), 11.9% had coronary artery disease (CAD) and 2.1% had renal or liver disease. Notably, the presence of a single or multiple comorbidities was associated with low overall survival compared to matched patients with no comorbidities (p = 0.007). Conclusion: The presence of single or multiple comorbidities is associated with inferior overall survival compared to matched groups without such pre-existing conditions.