Tania Losanno1, Cesare Gridelli2. 1. Division of Medical Oncology, "S. Ottone Frangipane" Hospital, Ariano Irpino, Italy. 2. Division of Medical Oncology, "S.G. Moscati" Hospital, Città Ospedaliera, 8,Contrada Amoretta, 83100, Avellino, Italy. cgridelli@libero.it.
Abstract
PURPOSE OF REVIEW: Treatment of elderly patients with non-small-cell lung cancer (NSCLC) represents still a challenge for higher risk of comorbidity, deteriorations in physical, organ, and cognitive functions, a potentially different pharmacokinetics, diminished social support, and immunosenescense. Here, we aim to report and analyse the most relevant and recent literature defining the role of chemotherapy, targeted therapy, and immunotherapy in the first-line treatment of elderly patients with metastatic NSCLC. RECENT FINDINGS: In the past years, treatment of NSCLC was based on cytotoxic chemotherapy, but recently, new drugs are deeply changing therapeutic standards, such as targeted therapy for oncogene addicted NSCLC, and immunotherapy. Despite lung cancer is primarily a disease of the elderly, they are under-represented in clinical trials. Targeted therapies and immune checkpoint inhibitors are largely considered to be appropriated for elderly too, because of their manageability, and fewer side effects compared with cytotoxic chemotherapy. However, we need further investigations to define and to choose the better treatment option for each elderly patient.
PURPOSE OF REVIEW: Treatment of elderly patients with non-small-cell lung cancer (NSCLC) represents still a challenge for higher risk of comorbidity, deteriorations in physical, organ, and cognitive functions, a potentially different pharmacokinetics, diminished social support, and immunosenescense. Here, we aim to report and analyse the most relevant and recent literature defining the role of chemotherapy, targeted therapy, and immunotherapy in the first-line treatment of elderly patients with metastatic NSCLC. RECENT FINDINGS: In the past years, treatment of NSCLC was based on cytotoxic chemotherapy, but recently, new drugs are deeply changing therapeutic standards, such as targeted therapy for oncogene addicted NSCLC, and immunotherapy. Despite lung cancer is primarily a disease of the elderly, they are under-represented in clinical trials. Targeted therapies and immune checkpoint inhibitors are largely considered to be appropriated for elderly too, because of their manageability, and fewer side effects compared with cytotoxic chemotherapy. However, we need further investigations to define and to choose the better treatment option for each elderly patient.
Authors: A G Pallis; C Gridelli; J P van Meerbeeck; L Greillier; U Wedding; D Lacombe; J Welch; C P Belani; M Aapro Journal: Ann Oncol Date: 2009-08-28 Impact factor: 32.976