Targeted therapy and elderly people: A review

Amaury Daste; Camille Chakiba; Charlotte Domblides; Marine Gross-Goupil; Amandine Quivy; Alain Ravaud; Pierre Soubeyran

doi:10.1016/j.ejca.2016.10.005

Targeted therapy and elderly people: A review

Eur J Cancer. 2016 Dec:69:199-215. doi: 10.1016/j.ejca.2016.10.005. Epub 2016 Nov 15.

Authors

Amaury Daste¹, Camille Chakiba², Charlotte Domblides³, Marine Gross-Goupil³, Amandine Quivy³, Alain Ravaud⁴, Pierre Soubeyran²

Affiliations

¹ Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France; University of Bordeaux, Bordeaux, France. Electronic address: [email protected].
² University of Bordeaux, Bordeaux, France; Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
³ Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France.
⁴ Department of Medical Oncology, Hôpital Saint-André, Bordeaux University Hospital-CHU Bordeaux, France; University of Bordeaux, Bordeaux, France.

PMID: 27855351
DOI: 10.1016/j.ejca.2016.10.005

Abstract

The use of targeted therapy (TT) has radically changed the outcome of various cancers and introduces the era of personalised medicine. Elderly patients (≥65 years) represent the majority of cancer diagnoses and deaths by age group with an increase expected over the next decade. This group of patients is heterogeneous with three categories of patients: fit, vulnerable and frail, with specific treatment for each subgroup. In this review, we assess safety and efficacy of TT in elderly patients, principally from data of pivotal clinical trials with subgroup analysis, but elderly people represented a small percentage of the total number of patients. Few specific trials have been carried out for TT in elderly people with most patients considered to be fit. However, tolerance and efficacy of TT in elderly patients seems similar to that for younger patients, with an increase in incidence of specific adverse events in elderly patients for selected TTs. An adapted geriatric selection and strict monitoring could help to decrease toxicity, and specific clinical trials for elderly cancer patients would be useful.

Keywords: Adverse events; Elderly people; Targeted therapy.

Publication types

Review

MeSH terms

Aged
Aged, 80 and over
Anaplastic Lymphoma Kinase
Angiogenesis Inhibitors / therapeutic use
Antineoplastic Agents / therapeutic use*
Breast Neoplasms / drug therapy
Carcinoma, Non-Small-Cell Lung / drug therapy
Carcinoma, Renal Cell / drug therapy
Colorectal Neoplasms / drug therapy
Drug-Related Side Effects and Adverse Reactions / etiology
ErbB Receptors / antagonists & inhibitors
Female
Gastrointestinal Stromal Tumors / drug therapy
Humans
Kidney Neoplasms / drug therapy
Lung Neoplasms / drug therapy
Male
Melanoma / drug therapy
Molecular Targeted Therapy
Neoplasms / drug therapy*
Ovarian Neoplasms / drug therapy
Protein Kinase Inhibitors / therapeutic use
Proto-Oncogene Proteins B-raf / antagonists & inhibitors
Receptor Protein-Tyrosine Kinases / antagonists & inhibitors
Receptor, ErbB-2 / antagonists & inhibitors
Skin Neoplasms / drug therapy
TOR Serine-Threonine Kinases / antagonists & inhibitors
Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

Angiogenesis Inhibitors
Antineoplastic Agents
Protein Kinase Inhibitors
Vascular Endothelial Growth Factor A
Anaplastic Lymphoma Kinase
ErbB Receptors
Receptor Protein-Tyrosine Kinases
Receptor, ErbB-2
Proto-Oncogene Proteins B-raf
TOR Serine-Threonine Kinases