title: Tolerability of Raltitrexed ('Tomudex') in elderly patients with colorectal cancer.
abstract: OBJECTIVE
  Colorectal cancer (CRC) is one of the major health problems of the Western world and the proportion of elderly patients with CRC is growing. Raltitrexed ('Tomudex'), a specific thymidylate synthase inhibitor, has shown efficacy and manageable toxicity in elderly CRC patients. In this retrospective study, the tolerability of raltitrexed in patients with CRC was examined in relation to age.
  
  
  METHODS
  Toxicity parameters, graded according to World Health Organization criteria, were assessed in two patient groups: < 70 and > or = 70 years old. In total, 56% (50 out of 90) of patients treated with raltitrexed (3 mg/m2 as a 15-minute intravenous infusion every 3 weeks) were aged > 70 years (M:F 28:22; Eastern Cooperative Oncology Group performance status 0-1:2 38:12).
  
  
  RESULTS
  Overall, 437 cycles of chemotherapy were administered and grade 3-4 toxicity was reported in < 10% of patients. There were no clinically significant differences between the two age groups, apart from grade 3-4 asthenia, which was reported by 6% and 0% of patients aged > or = 70 and < 70 years, respectively. This was in spite of a significantly lower calculated mean creatinine clearance in patients aged > or = 70 years compared with those patients < 70 years of age.
  
  
  CONCLUSIONS
  The raltitrexed toxicity profile does not appear to be significantly influenced by age; however caution is recommended in the management of elderly patients, particularly in the presence of impaired renal function.
authors.affiliation: National Cancer Institute of Genoa, Section of Rome, Department of Experimental Medicine and Pathology, La Sapienza University of Rome, Rome, Italy. adriana.romi@tin.it
authors.forename: Adriana
authors.initials: A
authors.lastname: Romiti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.forename: Marisa
authors.initials: M
authors.lastname: Di Seri
authors.forename: Raffaele
authors.initials: R
authors.lastname: Masciangelo
authors.forename: Silvia
authors.initials: S
authors.lastname: Mezi
authors.forename: Attilio
authors.initials: A
authors.lastname: Verì
authors.forename: Lucia
authors.initials: L
authors.lastname: Santuari
authors.forename: Bruno
authors.initials: B
authors.lastname: Vincenzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Brescia
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchei
authors.forename: Luigi
authors.initials: L
authors.lastname: Frati
authors.forename: Silverio
authors.initials: S
authors.lastname: Tomao
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D012189:Retrospective Studies; D012737:Sex Factors; D013876:Thiophenes / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000964:Antimetabolites, Antineoplastic; D011799:Quinazolines; D013876:Thiophenes; D003404:Creatinine; C068874:raltitrexed