Pharmacology of antineoplastic agents in older cancer patients

Persons over the age of 65 years are the fastest growing segment of the United States population. In the next 30 years it will comprise over 20% of the population. Fifty percent of all cancers occur in this age group and therefore there will be an expected rise in the total cancer burden. Data is be...

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Bibliographic Details
Published in:Critical reviews in oncology/hematology 2003-05, Vol.46 (2), p.101-114
Main Authors: Lichtman, Stuart M., Skirvin, J.Andrew, Vemulapalli, Sunitha
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Aged, 80 and over
Aging - metabolism
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - pharmacokinetics
Chemotherapy
Comorbidity
Drug Administration Schedule
Elderly
Geriatric oncology
Geriatrics
Humans
Infusions, Intravenous
Oncology
Patient Compliance
Pharmacodynamics
Pharmacokinetics
Pharmacology
Toxicity
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Summary:Persons over the age of 65 years are the fastest growing segment of the United States population. In the next 30 years it will comprise over 20% of the population. Fifty percent of all cancers occur in this age group and therefore there will be an expected rise in the total cancer burden. Data is becoming available which will better guide the use of chemotherapy in the older patient population. Studies will be presented discussing pharmacokinetic data on a number of chemotherapeutic agents with an emphasis on those which have entered practice over the past few years. Many of these agents seem to have a beneficial therapeutic index, particularly in regard to older patients. There has also been an increasing trend toward the use of oral chemotherapy. Factors that must be considered in choosing chemotherapy include limitations of saturability of absorption, patient compliance and the pharmacokinetic and pharmacodynamic changes which occur in older patients. Interpatient variability and age related changes in drug metabolism are discussed. Careful attention to the physiologic changes with age, and dose adjustments necessary for end organ dysfunction (renal, hepatic) are needed to ensure the safe administration of chemotherapy.
ISSN:1040-8428
1879-0461
DOI:10.1016/S1040-8428(02)00120-8