Effect of Age on Systemic Exposure and Haematological Toxicity of Carboplatin in Advanced Non-Small Cell Lung Cancer Patients

Merino-Sanjuán, Matilde; Monteiro, Joaquim; Porta-Oltra, Begoña; Maestu, Inmaculada; Almenar, D.; Jiménez-Torres, N.V.

doi:10.1111/j.1742-7843.2011.00753.x

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Despite this per protocol dose adjustment, exposure was similar in both groups. Age was a significant predictor of carboplatin clearance, showing a 31% mean clearance decrease in patients aged 70 years or over compared to younger patients [ 107 ].…”

Section: Resultsmentioning

confidence: 99%

Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer

Crombag

Joerger

Thürlimann

et al. 2016

Cancers

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Background: Elderly patients receiving anticancer drugs may have an increased risk to develop treatment-related toxicities compared to their younger peers. However, a potential pharmacokinetic (PK) basis for this increased risk has not consistently been established yet. Therefore, the objective of this study was to systematically review the influence of age on the PK of anticancer agents frequently administered to elderly breast cancer patients. Methods: A literature search was performed using the PubMed electronic database, Summary of Product Characteristics (SmPC) and available drug approval reviews, as published by EMA and FDA. Publications that describe age-related PK profiles of selected anticancer drugs against breast cancer, excluding endocrine compounds, were selected and included. Results: This review presents an overview of the available data that describe the influence of increasing age on the PK of selected anticancer drugs used for the treatment of breast cancer. Conclusions: Selected published data revealed differences in the effect and magnitude of increasing age on the PK of several anticancer drugs. There may be clinically-relevant, age-related PK differences for anthracyclines and platina agents. In the majority of cases, age is not a good surrogate marker for anticancer drug PK, and the physiological state of the individual patient may better be approached by looking at organ function, Charlson Comorbidity Score or geriatric functional assessment.

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Section: Resultsmentioning

confidence: 99%

Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer

Crombag

Joerger

Thürlimann

et al. 2016

Cancers

View full text Add to dashboard Cite

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A review of the management of elderly patients with non-small-cell lung cancer

et al. 2015

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Most patients with non-small-cell lung cancer (NSCLC) are elderly but evidence to guide appropriate treatment decisions for this age group is generally scant. Careful evaluation of the elderly should be undertaken to ensure that treatment appropriate for the stage of the tumour is guided by patient characteristics and not by age. The Comprehensive Geriatric Assessment (CGA) remains the preferred option, but briefer tools may be appropriate to select patients for further evaluation. The predicted outcome should be used to guide management decisions together with a reappraisal of polypharmacy. Patient expectations should also be taken into account. Management recommendations are generally similar to those of general guidelines for the NSCLC population, although the risks of surgery and toxicity of chemotherapy and radiotherapy are often increased in the elderly compared with younger patients; therefore, patients should be closely scrutinised and subjected to a CGA to ensure suitability of the planned treatment. If surgery is indicated, then lobectomy is generally the preferred option, although limited resection may be more feasible for some. Radiotherapy with curative intent is an alternative, with stereotactic body radiotherapy the most likely preferred modality. Adjuvant chemotherapy is also an appropriate approach, whereas adjuvant radiotherapy is generally not recommended. Concurrent chemoradiotherapy should be considered for elderly patients with inoperable locally advanced disease and chemotherapy for advanced/metastatic disease. Efforts should also be made to increase participation of elderly patients with NSCLC in clinical trials, thereby enhancing evidence-based treatment decisions for this majority group. This will require overcoming barriers relating to trial design and to physician and patient awareness and attitudes.

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Pharmacokinetics of Anticancer Drugs Used in Treatment of Older Adults With Colorectal Cancer: A Systematic Review

Shafiei

Yoon

McLachlan

et al. 2019

Therapeutic Drug Monitoring

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Purpose: Older adults with cancer experience more toxicity from anticancer therapy, possibly because of age-related changes in the pharmacokinetic (PK) profile of anticancer drugs. We aimed to evaluate studies investigating the effect of aging on the PK of anticancer therapies used in the treatment of colorectal cancer (CRC). Methods: A systematic literature search of EMBASE and PubMed was performed to find eligible studies that assessed the effect of age on the PK of anticancer therapies used in the treatment of CRC. Results: The 21 eligible studies included 17 prospective studies and 4 pooled analyses of prospective studies. Of these, PK of 5-fluorouracil (5-FU) was determined in 7 studies, oxaliplatin in 2 studies, capecitabine in 3 studies, irinotecan in 4 studies, bevacizumab in 1 study, cetuximab in 3 studies, and panitumumab in 1 study. Studies included a median of 44 patients and had varying definitions for older adults: 65 years or older (3 studies), older than 70 years (3 studies), or older than 75 years (1 study). Increasing age significantly affected the PK parameters of irinotecan with a 7%–8% reduction in CL (P < 0.001) for every 10 years in patients older than 60 years and an increase in area under the curve (r = 0.44, P = 0.007) and Cmax (r = 0.42, P = 0.009). Conclusions: Older age mainly influences PK of irinotecan and, to some extent, that of capecitabine, 5-FU, and panitumumab, but there is limited evidence for age-related changes in PK of other anticancer therapies used in the management of older adults with CRC. Factors other than PK may be responsible for the greater toxicity of these agents experienced by older adults.

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Effect of Age on Systemic Exposure and Haematological Toxicity of Carboplatin in Advanced Non-Small Cell Lung Cancer Patients

Cited by 3 publications

References 30 publications

Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer

Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer

A review of the management of elderly patients with non-small-cell lung cancer

Pharmacokinetics of Anticancer Drugs Used in Treatment of Older Adults With Colorectal Cancer: A Systematic Review

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