Recent developments in the pharmacology of anticancer drugs in the elderly

The aging of the population has focused interest on the care of elderly cancer patients. Data are becoming available that will better guide the use of chemotherapy. Recent studies are presented discussing new pharmacokinetic data on a number of chemotherapeutic agents, with an emphasis on those recently entering clinical practice. These agents seem to have a beneficial therapeutic index, particularly regarding elderly patients. They include gemcitabine, vinorelbine, the taxanes, anthracyclines, platinum compounds, topoisomerase I and II inhibitors, and the oral fluoropyrimidines. Careful attention to the physiologic changes with age along with dose adjustments for end-organ dysfunction (renal, hepatic) must be done to ensure the safe administration of chemotherapy.