title: Tyrosine Kinase Inhibitors for the Elderly.
abstract: Until few years ago non-specific cytotoxic agents were considered the tip of the arrow as first line treatment for lung cancer. However; age > 75 was considered a major drawback for this kind of therapy. Few exceptions were made by doctors based on the performance status of the patient. The side effects of these agents are still severe for several patients. In the recent years further investigation of the cancer genome has led to targeted therapies. There have been numerous publications regarding novel agents such as; erlotinib, gefitinib and afatinib. In specific populations these agents have demonstrated higher efficiency and this observation is explained by the overexpression of the EGFR pathway in these populations. We suggest that TKIs should administered in the elderly, and with the word elderly we propose the age of 75. The treating medical doctor has to evaluate the performance status of a patient and decide the best treatment in several cases indifferent of the age. TKIs in most studies presented safety and efficiency and of course dose modification should be made when necessary. Comorbidities should be considered in any case especially in this group of patients and the treating physician should act accordingly.
authors.affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hohenforst-Schmidt
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Steinheimer
authors.affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.
authors.forename: Naim
authors.initials: N
authors.lastname: Benhassen
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Tsiouda
authors.affiliation: 3. Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Baka
authors.affiliation: 4. Division of Pulmonary and Critical Care Medicine, Sheikh Zayed Cardiovascular & Critical Care Tower, Baltimore, U.S.A.
authors.forename: Lonny
authors.initials: L
authors.lastname: Yarmus
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Grigoris
authors.initials: G
authors.lastname: Stratakos
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Organtzis
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Pataka
authors.affiliation: 5. Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.affiliation: 6. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Karapantzos
authors.affiliation: 6. Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Karapantzou
authors.affiliation: 8. Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany.
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.affiliation: 9. Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Thrace, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Zissimopoulos
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Pitsiou
authors.affiliation: 2. Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 7. Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA.
authors.forename: Yan-Gao
authors.initials: YG
authors.lastname: Man
authors.affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Rittger
keywords: afatinib; elderly; erlotinib; gefitinib; targeted therapies