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Chemotherapy in the elderly: pharmacologic considerations
1Don Monti Division of Medical Oncology, Department of Medicine, North Shore University Hospital-New York University School of Medicine, Manhasset 11030, USA. lichtman@nshs.edu
Background:
The aging of the population has focused interest on the care of elderly cancer patients. A better understanding of the effects of chemotherapeutic agents on older patients with cancer will help to determine the appropriate use of chemotherapy for this age group.
Methods:
The authors review recent studies and present pharmacokinetic data on several chemotherapeutic agents, particularly those that have recently become available.
Results:
Agents such as gemcitabine, vinorelbine, the taxanes, anthracyclines, platinum compounds, topoisomerase I and II inhibitors, and the oral fluoropyrimidines appear to have a beneficial therapeutic index in elderly patients.
Conclusions:
Careful attention to the physiologic changes associated with aging, along with dose adjustments for end-organ dysfunction (eg, renal and hepatic), is necessary to ensure the safe administration of antitumor chemotherapy to the elderly.