title: [Tyrosine kinase inhibiting the VEGF pathway and elderly people: Tolerance, pre-treatment assessment and side effects management].
abstract: Angiogenesis inhibition is a major antitumor strategy that has emerged during the last decade. Oral tyrosine kinase inhibitors (TKI) targeting the VEGF receptor, including sunitinib, sorafenib, axitinib, regorafenib, pazopanib, and vandetanib reduce tumor growth and metastasis. These agents are approved for the treatment of metastatic diseases in first or second-line. They display a narrow therapeutic index. However, data in the elderly and/or in patients with multiple illnesses remain scarce. This population is classically excluded from clinical trials. The aim of this review is to provide an overview of existing literature regarding antiangiogenic TKI tolerance in the elderly (>70 years old). We also highlight key points of the pre-therapeutic evaluation and summarize the management of common toxicities.
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Bretagne
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France. Electronic address: pascaline.boudou@aphp.fr.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Boudou-Rouquette
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huillard
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, laboratoire de pharmacologie et toxicologie, Paris, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Thomas-Schoemann
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, service de gériatrie, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Chahwakilian
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, service de gériatrie, Paris, France.
authors.forename: Galdric
authors.initials: G
authors.lastname: Orvoen
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Arrondeau
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Tlemsani
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Anatole
authors.initials: A
authors.lastname: Cessot
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, service de cardiologie, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Cabanes
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, laboratoire de pharmacologie et toxicologie, Paris, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Blanchet
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, hôpital Broca, hôpital Cochin-Port-Royal, service de gastro-entérologie, Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.affiliation: Hôpitaux universitaires Paris centre, université Paris Descartes, CERIA, Center for Research on Angiogenesis Inhibitors, ARIANE, hôpital Broca, hôpital Cochin-Port-Royal, service d'oncologie médicale, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000077784:Axitinib; D005221:Fatigue / Q000139:chemically induced; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D007191:Indazoles / Q000009:adverse effects; D007211:Indoles / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000009:adverse effects; D010880:Piperidines / Q000009:adverse effects; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011725:Pyridines / Q000009:adverse effects; D011758:Pyrroles / Q000009:adverse effects; D011799:Quinazolines / Q000009:adverse effects; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors*; D000077157:Sorafenib; D000077210:Sunitinib
chemical_list: D020533:Angiogenesis Inhibitors; D007093:Imidazoles; D007191:Indazoles; D007211:Indoles; D010671:Phenylurea Compounds; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011758:Pyrroles; D011799:Quinazolines; C559147:regorafenib; D009536:Niacinamide; D000077157:Sorafenib; D000077784:Axitinib; D040262:Receptors, Vascular Endothelial Growth Factor; D000077210:Sunitinib; C452423:vandetanib
keywords: Angiogenesis; Angiogenèse; Elderly people; Inhibiteur VEGF; Sujets âgés; Toxicity; Toxicité; VEGF inhibitor