title: Pharmacotherapy for treatment of lung cancer in the elderly.
abstract: BACKGROUND
  The chance for elderly patients with NSCLC to receive chemotherapy decreases significantly with age. In addition, older patients are often underrepresented in clinical trials. Consequently, due to the paucity of data, evidence-based decisions with regard to chemotherapy treatment strategies in the elderly are lacking.
  
  
  METHODS
  We performed a literature search to identify mainly randomized trials focusing on treatment of NSCLC in older patients with chemotherapy and targeted therapy, toxicity and quality of life. In conclusion, the efficacy of regular chemotherapy and targeted therapy seems quite similar in older patients compared to their younger counterparts, with increased toxicity, but acceptable. However, these data are mostly derived from subgroup analyses and highly selected fit patients, which may not represent the general older population.
  
  
  CONCLUSIONS
  Further research is necessary to investigate the role of a comprehensive geriatric assessment in older patients, before the start of a chemotherapeutic treatment. Proteomic tests can have potential in the future, if these tests turn out to be able to separate patients with advanced NSCLC into groups with better or worse outcomes. It can be of special interest for the elderly population, to prevent unnecessary side effects of a possible inferior treatment.
authors: Jeroen Bosch Hospital, Department of Pulmonology , Henri Dunantstraat 1, 5223 GZ 's-Hertogenbosch , The Netherlands +31 0 73 5532615 ; +31 0 73 5532614 ; b.v.veggel@jbz.nl.
authors: Bianca A M H
authors: BA
authors: van Veggel
authors: Bonne
authors: B
authors: Biesma
authors: Egbert F
authors: EF
authors: Smit
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D009362:Neoplasm Metastasis; D010166:Palliative Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D000970:Antineoplastic Agents
keywords: EGFR-tyrosine kinase inhibitors; NSCLC; bevacizumab; chemotherapy; comprehensive geriatric assessment; elderly patients; platinum-based chemotherapy; proteomic tests