Treatment of Advanced Non–Small-Cell Lung Cancer in the Elderly: From Best Supportive Care to the Combination of Platin-Based Chemotherapy and Targeted Therapies

Lung cancer in elderly patients is an increasingly common problem for the oncology practitioner. Because most patients with non–small-cell lung cancer (NSCLC) have advanced disease at diagnosis, chemotherapy is the mainstay of management. Elderly patients often present with medical and physiological characteristics that make the selection of their optimal treatment more challenging. Unfortunately, as a result, these patients are at risk of being undertreated and being included in clinical trials only rarely. Moreover, many of these patients have preexisting comorbid conditions that, independently of cancer-related symptoms, may adversely affect organ function and influence functional status. Furthermore, comorbidities often require treatment with multiple drugs, which may interfere with cancer treatment or its toxicity profile.