International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients--an analysis of the medical literature.
The elderly comprise the majority of patients with cancer and are the recipients of the greatest amount of chemotherapy. Unfortunately, there is a lack of data to make evidence-based decisions with regard to chemotherapy. This is due to the minimal participation of older patients in clinical trials and that trials have not systematically evaluated chemotherapy. This article reviews the available information with regard to chemotherapy and aging provided by a task force of the International Society of Geriatric Oncology (SIOG). Due to the lack of prospective data, the conclusions and recommendations made are a consensus of the participants. Extrapolation of data from younger to older patients is necessary, particularly to those patients older than 80 years, for which data is almost entirely lacking. The classes of drugs reviewed include alkylators, antimetabolites, anthracyclines, taxanes, camptothecins, and epipodophyllotoxins. Clinical trials need to incorporate an analysis of chemotherapy in terms of the pharmacokinetic and pharmacodynamic effects of aging. In addition, data already accumulated need to be reanalyzed by age to aid in the management of the older cancer patient.
Lichtman
Stuart M
SM
Memorial Sloan-Kettering Cancer Center, Commack, New York 11725, USA. lichtmas@mskcc.org
Wildiers
Hans
H
Chatelut
Etienne
E
Steer
Christopher
C
Budman
Daniel
D
Morrison
Vicki A
VA
Tranchand
Brigitte
B
Shapira
Iuliana
I
Aapro
Matti
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005853:Geriatrics; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D012307:Risk Factors
D000970:Antineoplastic Agents