Irinotecan in the treatment of elderly patients with advanced colorectal cancer

Abstract Irinotecan is an active drug in the first and subsequent lines of chemotherapy for patients with advanced colorectal cancer. Frequently, the elderly patients are excluded from receiving irinotecan alone or in combination, and on many occasions these patients receive an initial reduced dose...

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Bibliographic Details
Published in:Critical reviews in oncology/hematology 2008-12, Vol.68 (3), p.250-255
Main Authors: Sastre, Javier, Puente, Javier, García-Saenz, Jose A, Díaz-Rubio, Eduardo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic agents
Antineoplastic Agents, Phytogenic - therapeutic use
Biological and medical sciences
Camptothecin - analogs & derivatives
Camptothecin - therapeutic use
Chemotherapy
Clinical Trials as Topic
Colorectal cancer
Colorectal Neoplasms - drug therapy
Elderly patients
Female
Health Services for the Aged
Hematologic and hematopoietic diseases
Hematology, Oncology and Palliative Medicine
Humans
Irinotecan
Male
Medical sciences
Pharmacology. Drug treatments
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Summary:Abstract Irinotecan is an active drug in the first and subsequent lines of chemotherapy for patients with advanced colorectal cancer. Frequently, the elderly patients are excluded from receiving irinotecan alone or in combination, and on many occasions these patients receive an initial reduced dose of this drug. This revision has been focused in the role of irinotecan in elderly patients. Material and methods Data from pharmacokinetic studies, comparative analysis of prospective trials according to age and prospective studies with irinotecan alone or irinotecan-combinations in the elderly have been revised and put into context. Results Either pharmacokinetic and clinical data suggest that fit elderly patients may tolerate irinotecan as well as the younger population. Response rate and survival achieved in elderly patients with irinotecan combinations seem to be equivalent to that obtained in younger patients. Conclusion Elderly patients with advanced colorectal cancer should be carefully evaluated in order to be classified as fit or not fit through a comprehensive geriatric assessment. For the group of fit elderly patients, irinotecan may be used as in the younger population.
ISSN:1040-8428
1879-0461
DOI:10.1016/j.critrevonc.2008.05.008