Chemotherapy in the elderly: pharmacologic considerations.
BACKGROUND
The aging of the population has focused interest on the care of elderly cancer patients. A better understanding of the effects of chemotherapeutic agents on older patients with cancer will help to determine the appropriate use of chemotherapy for this age group.


METHODS
The authors review recent studies and present pharmacokinetic data on several chemotherapeutic agents, particularly those that have recently become available.


RESULTS
Agents such as gemcitabine, vinorelbine, the taxanes, anthracyclines, platinum compounds, topoisomerase I and II inhibitors, and the oral fluoropyrimidines appear to have a beneficial therapeutic index in elderly patients.


CONCLUSIONS
Careful attention to the physiologic changes associated with aging, along with dose adjustments for end-organ dysfunction (eg, renal and hepatic), is necessary to ensure the safe administration of antitumor chemotherapy to the elderly.
Lichtman
S M
SM
Don Monti Division of Medical Oncology, Department of Medicine, North Shore University Hospital-New York University School of Medicine, Manhasset 11030, USA. lichtman@nshs.edu
Villani
G
G
D000368:Aged; D000375:Aging / Q000378:metabolism*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D007677:Kidney Function Tests; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D018570:Risk Assessment
D000970:Antineoplastic Agents