[Medical oncology treatment].

Area of Science:

• Oncology
• Geriatric Medicine
• Clinical Pharmacology

Background:

• Breast cancer disproportionately affects patients over 65, yet robust safety and efficacy data for medical treatments in this demographic are scarce.
• Current treatment guidelines for older breast cancer patients often rely on expert consensus rather than extensive clinical trial evidence.
• Understanding treatment outcomes in elderly populations is crucial for personalized cancer care.

Approach:

• This literature review synthesizes existing data on the safety and efficacy of major medical oncology treatments for breast cancer in patients aged 65 and older.
• The review specifically examines chemotherapy, cyclin-dependent kinase 4/6 inhibitors, human epidermal growth factor receptor-2-targeted agents, antibody-drug conjugates, and immunotherapies.
• Evidence from clinical trials and real-world data was evaluated to assess treatment tolerability and effectiveness.

Key Points:

• Chemotherapy in older adults shows variable efficacy and safety profiles, necessitating careful dose adjustments and supportive care.
• Cyclin-dependent kinase 4/6 inhibitors demonstrate a generally favorable safety profile in elderly patients, improving progression-free survival.
• Targeted therapies like anti-HER2 agents and antibody-drug conjugates offer effective options, though specific toxicities require monitoring in older individuals.
• Immunotherapy presents a promising avenue, but its use in the elderly requires further investigation regarding efficacy and immune-related adverse events.

Conclusions:

• Evidence for medical oncology treatments in older breast cancer patients is growing but remains limited, highlighting the need for dedicated research.
• Tailoring treatment strategies based on individual patient factors, including comorbidities and frailty, is essential for optimizing outcomes in this population.
• Further clinical trials focusing on geriatric populations are imperative to establish evidence-based guidelines for breast cancer management in older adults.