Key result
Age-related changes in pharmacokinetics in older women with breast cancer are usually not clinically significant, and when present, are often due to comorbidity or drug interactions.
Why the study?
Does advancing age affect the pharmacokinetics and pharmacodynamics of breast cancer treatments in older women?
Does advancing age affect the pharmacokinetics and pharmacodynamics of breast cancer treatments in older women?
Older breast cancer patients should be considered for standard therapies with geriatric-specific assessment, as age-related pharmacokinetic changes are usually not clinically significant.
Underscores pharmacotherapy caution in older breast cancer patients; leaves open evidence-based strategies pending inclusive trials.
INTRODUCTION: The aging of the population will increase the number of breast cancer patients requiring treatment in both the adjuvant and metastatic setting. Hormones, chemotherapy and targeted drugs all have a role in treatment. Older patients have been underrepresented in clinical trials making evidence-based decisions difficult. The increase in comorbidity and aging, polypharmacy and changes in function make pharmacotherapy decisions more complicated. Knowledge of the issues is critical in the prescribing of effective and safe therapy. There are factors associated with advancing age that can result in pharmacokinetic and pharmacodynamic variations in processing of hormonal agents, chemotherapy and targeted drugs. AREAS COVERED: A review of the literature pertaining to pharmacokinetic changes in aging in breast cancer was untaken. Studies are reviewed involving single agents and some combinations. EXPERT OPINION: Older patients should be considered for standard therapies. Their specific problems need to be evaluated by geriatric-specific assessment including functional status, end organ dysfunction and polypharmacy. There are few instances for age-related changes in pharmacokinetics and when present are usually not clinically significant. When changes are present, they are often the result of comorbidity, drug interactions and drug scheduling issues. The older patients may be more sensitive to certain toxicities such as cardiac toxicity, neuropathy and myelosuppression.
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Singh et al. (2015) conducted a review in Breast cancer. Advancing age was evaluated on Pharmacokinetic and pharmacodynamic variations. Age-related changes in pharmacokinetics in older women with breast cancer are usually not clinically significant, and when present, are often due to comorbidity or drug interactions.
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