Irinotecan in the treatment of elderly patients with advanced colorectal cancer.
Irinotecan is an active drug in the first and subsequent lines of chemotherapy for patients with advanced colorectal cancer. Frequently, the elderly patients are excluded from receiving irinotecan alone or in combination, and on many occasions these patients receive an initial reduced dose of this drug. This revision has been focused in the role of irinotecan in elderly patients.


METHODS
Data from pharmacokinetic studies, comparative analysis of prospective trials according to age and prospective studies with irinotecan alone or irinotecan-combinations in the elderly have been revised and put into context.


RESULTS
Either pharmacokinetic and clinical data suggest that fit elderly patients may tolerate irinotecan as well as the younger population. Response rate and survival achieved in elderly patients with irinotecan combinations seem to be equivalent to that obtained in younger patients.


CONCLUSIONS
Elderly patients with advanced colorectal cancer should be carefully evaluated in order to be classified as fit or not fit through a comprehensive geriatric assessment. For the group of fit elderly patients, irinotecan may be used as in the younger population.
Sastre
Javier
J
Medical Oncology Department, San Carlos Hospital, c/Martin Lagos s/n, 28040 Madrid, Spain. giuseppedilorenzoncol@hotmail.com <giuseppedilorenzoncol@hotmail.com>
Puente
Javier
J
García-Saenz
Jose A
JA
Díaz-Rubio
Eduardo
E
D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D000077146:Irinotecan; D008297:Male
D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin