title: International Society of Geriatric Oncology (SIOG) recommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency.
abstract: A SIOG taskforce was formed to discuss best clinical practice for elderly cancer patients with renal insufficiency. This manuscript outlines recommended dosing adjustments for cancer drugs in this population according to renal function. Dosing adjustments have been made for drugs in current use which have recommendations in renal insufficiency and the elderly, focusing on drugs which are renally eliminated or are known to be nephrotoxic. Recommendations are based on pharmacokinetic and/or pharmacodynamic data where available. The taskforce recommend that before initiating therapy, some form of geriatric assessment should be conducted that includes evaluation of comorbidities and polypharmacy, hydration status and renal function (using available formulae). Within each drug class, it is sensible to use agents which are less likely to be influenced by renal clearance. Pharmacokinetic and pharmacodynamic data of anticancer agents in the elderly are needed in order to maximise efficacy whilst avoiding unacceptable toxicity.
authors.affiliation: Memorial Sloan-Kettering Cancer Centre, New York, USA.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Lichtman
authors.forename: Hans
authors.initials: H
authors.lastname: Wildiers
authors.forename: Vincent
authors.initials: V
authors.lastname: Launay-Vacher
authors.forename: Christopher
authors.initials: C
authors.lastname: Steer
authors.forename: Etienne
authors.initials: E
authors.lastname: Chatelut
authors.forename: Matti
authors.initials: M
authors.lastname: Aapro
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004347:Drug Interactions; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D051437:Renal Insufficiency / Q000150:complications*
chemical_list: D000970:Antineoplastic Agents