title: Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer.
abstract: Lung cancer is the most common cause of cancer-related mortality in men and women. Non-small cell lung cancer (NSCLC) represents close to 90% of all lung cancers. When diagnosed, >50% of patients are >65 years old. Through an improved understanding of the molecular mechanisms involved in lung oncogenesis, molecular-targeted approaches have become an essential element for the treatment of patients with NSCLC. As the toxicity profiles of the techniques are definitely more favorable compared with chemotherapy, they are particularly attractive for use in elderly patients, who are potentially more susceptible to the toxicity of systemic oncological therapies. However, studies on the activity of molecular-targeted agents in this aged patient setting are much more limited compared with those in their younger counterparts. In the present review, the literature on molecular-targeted therapy for elderly patients with advanced NSCLC is discussed. It is concluded that bevacizumab should be reserved only for highly select elderly patients with advanced NSCLC when the clinician deems it useful in the face of acceptable toxicities. In elderly patients with advanced epidermal growth factor receptor mutation-positive NSCLC, erlotinib and gefitinib appear to repeat the same favorable performance as that documented on a larger scale in the overall population of patients with activating mutations. A good toxicity profile is also confirmed for active molecules on different pathways, such as crizotinib.
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Giovanna
authors: G
authors: Antonelli
authors: Laboratory of Translational Oncology and Functional Genomics, Section of General Pathology and Oncology, Department of Biomedical Sciences, University of Catania, Catania I-95124, Italy.
authors: Massimo
authors: M
authors: Libra
authors: Department of Surgical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Vincenzo
authors: V
authors: Panebianco
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Alessia Erika
authors: AE
authors: Russo
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Felice Vito
authors: FV
authors: Vitale
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Paolo
authors: P
authors: Colina
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Alessandro
authors: A
authors: D'Angelo
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Rosalba
authors: R
authors: Rossello
authors: Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
authors: Francesco
authors: F
authors: Ferraù
keywords: advanced non-small cell lung cancer; elderly patients; molecular-targeted therapy; safety profile