Key result
Increasing age may cause clinically-relevant pharmacokinetic differences for anthracyclines and platina agents, though age alone is generally not a good surrogate marker for anticancer drug PK.
Why the study?
Does increasing age influence the pharmacokinetics of selected anticancer drugs in elderly breast cancer patients?
Systematic Review
Does increasing age influence the pharmacokinetics of selected anticancer drugs in elderly breast cancer patients?
Age alone is generally not a reliable surrogate marker for anticancer drug pharmacokinetics in elderly breast cancer patients; physiological state and organ function should be considered instead.
PK changes with age remain inconsistent for breast cancer agents; leaves open whether pharmacokinetics explain increased toxicity in elderly patients.
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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Crombag et al. (2016) conducted a systematic review in Breast cancer. Increasing age vs. Younger age was evaluated on Pharmacokinetics of selected anticancer drugs. Increasing age may cause clinically-relevant pharmacokinetic differences for anthracyclines and platina agents, though age alone is generally not a good surrogate marker for anticancer drug PK.
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