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Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer
Giovanna Antonelli1, Massimo Libra2, Vincenzo Panebianco3
1Department of Medical Oncology, San Vincenzo Hospital, Taormina, Messina I-98039, Italy.
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.
Insights
Molecular-targeted therapies show promise for elderly patients with advanced non-small cell lung cancer (NSCLC). Erlotinib, gefitinib, and crizotinib demonstrate favorable outcomes and toxicity profiles in this population.
Area of Science:
- Oncology
- Geriatric Medicine
- Pharmacology
Background:
- Non-small cell lung cancer (NSCLC) is a leading cause of cancer mortality, with over 50% of diagnoses in patients aged 65 and older.
- Molecular-targeted therapies offer improved toxicity profiles compared to traditional chemotherapy, making them particularly relevant for elderly patients.
- Limited data exists on the efficacy and safety of molecular-targeted agents in older adults with advanced NSCLC.
Purpose of the Study:
- To review the current literature on molecular-targeted therapy for elderly patients with advanced NSCLC.
- To evaluate the efficacy and safety of specific molecular-targeted agents in this patient population.
Main Methods:
- Literature review of studies focusing on molecular-targeted therapies in elderly patients with advanced NSCLC.
- Analysis of data regarding efficacy, safety, and toxicity profiles of various agents.
Main Results:
- Bevacizumab should be used cautiously in select elderly patients with advanced NSCLC due to potential toxicities.
- Erlotinib and gefitinib show comparable favorable performance in elderly patients with EGFR mutation-positive advanced NSCLC as in the general population.
- Crizotinib and other agents targeting different pathways exhibit a good toxicity profile in elderly patients.
Conclusions:
- Molecular-targeted therapies are a viable and often preferable treatment option for elderly patients with advanced NSCLC.
- Specific agents like erlotinib, gefitinib, and crizotinib demonstrate good efficacy and safety in this demographic.
- Further research is warranted to optimize the use of molecular-targeted therapies in the growing elderly population diagnosed with NSCLC.
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