Key result
Age-related organ decline and comorbidities alter the safety and pharmacokinetics of systemic anticancer therapies.
Why the study?
Cancer is a disease of older adults with a continuum of fitness and frailty, posing unique challenges to managing systemic anticancer treatments.
Systematic integration of geriatrics principles is essential in managing older adults with cancer due to age-related biological changes affecting treatment response.
Supports geriatric assessment before anticancer therapy in older adults; leaves open need for prospective age-specific dosing trials.
PURPOSE OF REVIEW: Cancer is a disease of older adults, where fitness and frailty are a continuum. This aspect poses unique challenges to the management of cancer in this population. In this article, we review the biological aspects influencing the efficacy and safety of systemic anticancer treatments. RECENT FINDINGS: The organ function decline associated with the ageing process affects multiple systems, including liver, kidney, bone marrow, heart, muscles and central nervous system. These can have a significant impact on the pharmacokinetics and pharmacodynamics of systemic anticancer agents. Comorbidities also represent a key aspect to consider in decision-making. Renal disease, liver conditions and cardiovascular risk factors are prevalent in this age group and may impact the risk of adverse outcomes in this setting. SUMMARY: The systematic integration of geriatrics principles in the routine management of older adults with cancer is a unique opportunity to address the complexity of this population and is standard of care based on a wide range of benefits. This approach should be multidisciplinary and involve careful discussion with hospital pharmacists.
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Crimmin et al. (2021) conducted a review in Cancer in older adults. Systemic anticancer treatments was evaluated. Age-related organ function decline and comorbidities significantly impact the pharmacokinetics, pharmacodynamics, and safety of systemic anticancer treatments in older adults.
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