[The handling of anti-cancer drugs in elderly patients].
The management of elderly patients with cancer is not established. The use of antineoplastic agents (particularly of chemotherapy) raises a lot of questions. Efficiency and toxicity. Data come from subgroups of clinical trials and from selected populations. Chronological age itself does not contra-indicate chemotherapy. Pharmacokinetics. Physiologic and functional changes occur with aging but there is great inter-patient variability. Oral chemotherapy. Oral treatments underline the problem of compliance. Under-treatment. Elderly patients are under-represented in clinical trials. Relevant issues have to be defined individually and cancer's real place in patient's general situation has to be specified. Geriatric assessment. This tool has proved its usefulness in many domains for global management of elderly patients. A multidisciplinary team is necessary, under geriatrician coordination. The aim is to elaborate an individualized medico-social intervention program. Geriatric assessment in oncology. Its interest for cancer patients is shown by emerging reports but its routine use by oncologists is impossible. Treatment strategies. They are not validated.


CONCLUSIONS
New clinical and pharmacokinetic studies are necessary in order to specify the place of the various tools and to enhance the handling of such molecules.
Hôpital gériatrique Antoine Charial, Hospices civils de Lyon, Francheville. sylvain.gaujard@chu-lyon.fr
Sylvain
S
Gaujard
Gilles
G
Albrand
Marc
M
Bonnefoy
Philippe
P
Courpron
Gilles
G
Freyer
D000284:Administration, Oral; D000368:Aged / Q000523:psychology*; D000375:Aging / Q000378:metabolism / Q000523:psychology; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001711:Biotransformation; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D008658:Inactivation, Metabolic; D008508:Medication Errors / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology; D010349:Patient Compliance; D018579:Patient Selection; D012646:Self Administration
D000970:Antineoplastic Agents