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[Which drugs in Hemato-Oncology are Unnecessary or Inappropriate for Use in the Elderly?]
Abstract:
There is a vast amount of drugs and therapeutic regimens available today to treat hemato-oncological diseases. This offers new opportunities to close known gaps of undertreatment in older individuals with cancer, but also increases the risk of overtreatment in this patient group. Currently available criteria (drug listings) for potentially inadequate prescribing in the elderly are not matured enough to serve hemato-oncologists as a guidance when trying to identify unnecessary or inappropriate cancer medication in routine clinical practice. In some clinical situations (e. g., decision-making for adjuvant treatment), online tools that allow for a rough prediction of remaining life expectancy (without or with cancer) as well as chemotherapy toxicity could help to detect risks of overtreatment in individual patients, however. Avoiding chemotherapy in distinct therapeutic situations has become possible for some hematological and solid tumors due to a growing number of novel targeted (i. e. non-cytostatic) drugs. This development appears of particular benefit for elderly patients. The present review discusses tools that generally could support the identification of overtreatment in older patients with such diseases. Drug examples are presented for some common hemato-oncological entities.
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