Targeted therapy and elderly people: A review
Amaury Daste1, Camille Chakiba2, Charlotte Domblides3
1Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France; University of Bordeaux, Bordeaux, France.
European Journal of Cancer (Oxford, England : 1990)
|November 18, 2016
Summary
Targeted therapy (TT) shows promise for elderly cancer patients, with similar efficacy to younger adults. Careful patient selection and monitoring are key to managing increased adverse events in this growing population.
Area of Science:
- Oncology
- Geriatric Medicine
- Pharmacology
Background:
- Elderly patients (≥65 years) constitute the majority of cancer diagnoses and deaths.
- This demographic is heterogeneous, categorized as fit, vulnerable, or frail, requiring tailored treatments.
- Targeted therapy (TT) has revolutionized cancer treatment, ushering in personalized medicine.
Purpose of the Study:
- To review the safety and efficacy of targeted therapy (TT) in elderly cancer patients.
- To analyze data from pivotal clinical trials, focusing on subgroup analyses of older adults.
- To identify specific challenges and recommendations for TT use in the geriatric oncology population.
Main Methods:
- Systematic review of pivotal clinical trials involving targeted therapy.
- Analysis of subgroup data specifically for patients aged 65 and older.
- Assessment of safety profiles and efficacy outcomes in elderly cohorts.
Main Results:
- Elderly patients were often underrepresented in clinical trials, with most considered fit.
- The tolerance and efficacy of TT in elderly patients generally appear similar to younger patients.
- Certain TTs are associated with an increased incidence of specific adverse events in the elderly.
Conclusions:
- Adapted geriatric assessment and rigorous monitoring can mitigate TT toxicity in older adults.
- There is a need for dedicated clinical trials focusing on targeted therapy in elderly cancer patients.
- Personalized medicine approaches, including TT, require careful consideration of age-related factors.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
339
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
339
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
291
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
291
02:57Targeted Cancer Therapies
9.0K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
9.0K
02:57Targeted Cancer Therapies
1.7K
1.7K
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
307
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
307
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
783
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
783