Onkologie. 2010:4(1):24-28

Biological therapy of seniors

Mária Wagnerová
Východoslovenský onkologický ústav, a. s.

More than 50 % of cases of cancer are diagnosed in patients older than age 65. Elderly patients with cancer often present with medical

and physiological challenges that make the selection of their optimal treatment daunting. Unfortunately as a result, these patients are

often undertreated. Elderly are often excluded from participation in clinical trials and receive untested or inadeguate treatment. Targeted

therapy, characterized by a low toxicity profile, are potential treatment option for elderly patients. The key of successful management

is to define appropriate goals (cure or palliation) based on the natural history and extent of disease, physiology and life expectancy of

the patients, and cost benefit ratio of treatment options.

Keywords: cancer, therapy, seniors

Published: March 1, 2010  Show citation

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Wagnerová M. Biological therapy of seniors. Onkologie. 2010;4(1):24-28.
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References

  1. Cohen HJ. The cancer aging interface a research agenda J Clin Oncol may 10 2007; 25(14): 1945-1948.
  2. Repetto L, Venturino A, Fratino L, et al. Geriatric oncology: A clinical approach to the older patient with cancer. Eur J Cancer 2003; 39: 870-880. Go to original source... Go to PubMed...
  3. Balducci L. New paradigms for treating elderly patients with cancer: the Comprehensive Geriatric Assessment and guidelines for supportive care. J Support Oncol 2003; 1(suppl 2): 30-37. Go to PubMed...
  4. Exterman M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J. Clin Oncol May, 10 2007; 25(14): 1824-1831. Go to original source... Go to PubMed...
  5. Extermann M. Assessing elderly cancer patients. The SIOG Task Force on Oncogeriatric Assessment presents its findings to the experts. Cancer Futures 2003; 2: 155-157.
  6. Balducci L, Lyman GH. Patients aged > or = 70 are at high risk for neutropenic infection and should receive hemopoietic growth factors when treated with moderately toxic chemotherapy. J Clin Oncol 2001; 19: 1583-1585. Go to original source... Go to PubMed...
  7. Huria A, Lichtman SM, Gardes J, et al. Identifying vulnerable older adults with cancer integrating geriatric assessment into oncology practice. J Am Geriatr Soc. oct 2007; 55(10): 1604-1608. Go to original source... Go to PubMed...
  8. Extermann M. Measurement and impact of comorbidity in older cancer patients. Crit Rev Oncol Hematol 2000; 35: 181-200. Go to original source... Go to PubMed...
  9. Extermann M. Measuring comorbidity in older cancer patients. Eur J Cancer. 2000; 36: 453-471. Go to original source... Go to PubMed...
  10. Marx GM, Blake GM, Galani E, et al. Evaluation of the Cockroft-Gault, Jelliffe and Wright formulae in estimating renal function in elderly cancer patients. Ann Oncol 2004; 15: 291-295. Go to original source... Go to PubMed...
  11. Monfardini S, Ferrucci L, Fratino L, et al. Validation of a multidimensional evaluation scale for use in elderly cancer patients. Cancer 1996; 77: 395-401. Go to original source... Go to PubMed...
  12. Schrijvers D, Highley M, De Bruyn E, et al. Role of red blood cells in pharmacokinetics of chemotherapeutic agents. Anticancer Drugs 1999; 10: 147-153. Go to original source... Go to PubMed...
  13. Wildiers H, Jurcut R, Ganame J, et al. A pilot study to investigate the feasibility and cardiac effects of pegylated liposomal doxorubicin (PL-Dox) as adjuvant therapy in medically fit elderly breast cancer patients. Crit Rev Oncol Hematol 2008; 67: 133-138. Go to original source... Go to PubMed...
  14. Wildiers H, Highley MS, de Bruijn EA, et al. Pharmacology of anticancer drugs in the elderly population. Clin Pharmacokinet 2003; 42: 1213-1242. Go to original source... Go to PubMed...
  15. Klepin H, Mohile S, Hurria A. geriatric assessment in older patients with breast cancer, J Natl Compr Canc Netw. feb 2009; 7(2): 226-236. Go to original source... Go to PubMed...
  16. Lynch TJ, Bell DW, Sordella R, et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small cell lung cancer to gefitinib. N Engl J Med 2004; 350: 2129-2139. Go to original source... Go to PubMed...
  17. Shepherd FA, Pereira JR, Ciuleanu T, et al. Erlotinib in previously treated non-small cell lung cancer. N Engl J Med 2005; 353: 123-132. Go to original source... Go to PubMed...
  18. De Martinis M, Franceschi C, Monti D, Ginaldi L. Inflammation markers predicting frailty and mortality in the elderly. Exp Mol Pathol 2006; 80: 219-227. Go to original source... Go to PubMed...
  19. Yancik R, Wesley MN, Ries LA, et al. Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients: a population-based study. Cancer 1998; 82: 2123-2134. Go to original source...
  20. Evans WE, McLeod HL. Pharmacogenomics-drug disposition, drug targets, and side effects. N Engl J Med 2003; 348: 538-549. Go to original source... Go to PubMed...
  21. Maas HA, Janssen-Heijnen ML, Olde Rikkert MG, Machteld Wymenga AN. Comprehensive geriatric assessment and its clinical impact in oncology Eur J Cancer. oct 2007; 43(15): 2161-2169. Go to original source... Go to PubMed...
  22. Slamon DJ, Leyland-Jones B, Shak S, et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344: 783-792. Go to original source... Go to PubMed...
  23. Tortora G, Caputo R, Damiano V, et al. Combination of a selective cyclooxygenase-2 inhibitor with epidermal growth factor receptor tyrosine kinase inhibitor ZD1839 and protein kinase A antisense causes cooperative antitumor and antiangiogenic effect. Clin Cancer Res 2003; 9: 866-871.
  24. Vogel C, Cobleigh MA, Tripathy D, et al. First-line, single-agent Herceptin(R) (trastuzumab) in metastatic breast cancer: a preliminary report. Eur J Cancer 2001; 37(suppl 1): S25-S29. Go to original source...
  25. Crawford J, Dale DC, Lyman GH. Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer 2004; 100: 228-237. Go to original source... Go to PubMed...
  26. Merimsky J, et al. Erlotinib evaluation as a first line treatment option for elderly patients with advanced non small cell lung cancer: Oncol. hematol. 2006; 68(suppl. 2): S 26. Go to original source...
  27. Paez JG, Janne PA, Lee JC, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004; 304: 1497-1500. Go to original source... Go to PubMed...
  28. Rossi A, Maione P, Del Gaizo F, et al. Safety profile of gefitinib in advanced non-small cell lung cancer elderly patients with chronic renal failure: two clinical cases. Lung Cancer 2005; 47: 421-423. Go to original source... Go to PubMed...
  29. Scagliotti G, Rossi A, Novello S, et al. Gefitinib (ZD 1839) combined with gemcitabine or vinorelbine as singleagent in elderly patients with advanced non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 2004; 23: 633. Go to original source...
  30. Stahel R, Rossi A, Petruzelka L, Kosmidis P, et al. Lessons from the IRESSA Expanded Access Programme: gefitinib in special non-small cell lung cancer patient populations. Br J Cancer 89 2003; (Suppl 2): S19-S23. Go to original source... Go to PubMed...
  31. Flockhart D. Cytochrome P450 Drug-Interaction Table. Available at http://medicine.iupui.edu/flockhart/. Accessed January 17, 2005.
  32. Pao W, Miller VA. Epidermal growth factor receptor mutations, smallmolecule kinase inhibitors, and non-small cell lung cancer: Current knowledge and future directions. J Clin Oncol 2005; 23: 2556-2568. Go to original source... Go to PubMed...
  33. Cunningham D, Humblet Y, Siena S, et al. Cetuximab (C225) alone or in combination with irinotecan (CPT-11) in patients with epidermal growth factor receptor (EGFR) - positive, irinotecan-refractory metastatic colorectal cancer (MCRC). Proc Am Soc Clin Oncol 2003; 22: 1012a.
  34. Saltz LB, Meropol NJ, Loehrer PJ Sr, et al. Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol 2004; 22: 1201-1208. Go to original source... Go to PubMed...
  35. Sundararajan V, Mitra N, Jacobson JS, et al. Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Intern Med 2002; 136: 349-357. Go to original source... Go to PubMed...
  36. Cappuzzo F, Bartolini S, Ceresoli GL, et al. Efficacy and tolerability of gefitinib in pretreated elderly patients with advanced nonsmall cell lung cancer (NSCLC). Br J Cancer 2004; 90: 82-86. Go to original source... Go to PubMed...
  37. Ciardiello F, Caputo R, Damiano V, et al. Antitumor effects of ZD6474, a small-molecule vascular endothelial growth factor receptor tyrosine kinase inhibitor, with additional activity against epidermal growth factor receptor tyrosine kinase. Clin Cancer Res 2003; 9: 1546-1556.
  38. Des Guetz G, et al. Gefitinib in elderly lung cancer: Oncol hematol 68(Suppl 2): S47.
  39. Jackman D, Lucca J, Fidias P, et al. Phase II study of the EGFR tyrosine kinase inhibitor erlotinib in patients >= 70 years of age with previously untreated advanced non-small cell lung carcinoma. J Clin Oncol 2005; 23: 657. Go to original source... Go to PubMed...
  40. Tsao MS, Sakurada A, Cuts JC, et al. Erlotinib in lung cancer - molecular and clinical predictors of outcome. N Engl J Med 2005; 353: 133-144. Go to original source... Go to PubMed...
  41. ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of non-small-cell lung cancer (NSCLC). Ann Oncol 2001; 12: 1049-1050. Go to original source... Go to PubMed...
  42. Fukuoka M, Yano S, Giaccone G, et al. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small cell lung cancer. J Clin Oncol 2003; 21: 2237-2246. Go to original source... Go to PubMed...
  43. Gatzemeier U, Pluzanska A, Szczesna A, et al. Results of a phase III trial of erlotinib (OSI-774) combined with cisplatin and gemcitabine (GC) chemotherapy in advanced non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 2004; 23: 617. Go to original source...
  44. Gatzemeier U, Pluzanska A, Szczesna A, et al. Results of a phase III trial of erlotinib (OSI-774) combined with cisplatin and gemcitabine (GC) chemotherapy in advanced non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 2004; 23: 617. Go to original source...
  45. Herbst RS, Giaccone G, Schiller JH, et al. Gefitinib in combination with paclitaxel and carboplatin in advanced nonsmall cell lung cancer: a phase III trial INTACT 2. J Clin Oncol. 2004; 22: 785-794. Go to original source... Go to PubMed...
  46. Herbst RS, Prager D, Hermann R, et al. TRIBUTE: A Phase III Trial of Erlotinib Hydrochlride (OSI-744) Combined With Carboplatin and Paclitaxel Chemotherapy in Advanced NonSmall Cell Lung Cancer. J Clin Oncol 2005; 23: 5892-5899. Go to original source... Go to PubMed...
  47. Giaccone G, Herbst RS, Manegold C, et al. Gefitinib in combination with gemcitabine and cisplatin in advanced nonsmall cell lung cancer: a phase III trial INTACT 1. J Clin Oncol 2004; 22: 777-784. Go to original source... Go to PubMed...
  48. Gridelli C, Ardizzoni A, Le Chevalier T, et al. Treatment of advanced non-small-cell lung cancer patients with ECOG performance status 2: Results of an European Experts Panel. Ann Oncol 2004; 15: 419-426. Go to original source... Go to PubMed...
  49. Sandler AB, Gray R, Brahmer J, et al. Randomized phase II/III trial of paclitaxel plus carboplatin with or without bevacizumab (NSC #704865) in patients with advanced nonsquamous non-small cell lung cancer: An Eastern Cooperative Oncology Group (ECOG) Trial - E4599. J Clin Oncol 23/16S, ASCO Annual Meeting Proceedings: 2005; 1090 (A4). Go to original source...
  50. Johnson DH, Fehrenbacher L, Novotny WF, et al. Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small cell lung cancer. J Clin Oncol 2004; 22: 2184-2191. Go to original source... Go to PubMed...
  51. Thatcher T, Chang A, Parikh P, et al. ISEL: a phase III survival study comparing gefitinib (IRESSA) plus best supportive care (BSC) with placebo plus BSC, in patients with advanced NSCLC (NSCLC) who had received one or two prior chemotherapy regimens. Lung Cancer 2005; 49(Suppl 2): S4. Go to original source...
  52. Biganzoli L. Tolerability and efficacy of first line bevacizumab plus chemotherapy in elderly patients with advanced breast cancer: subpopulation analysis of the MO19391 study annual meeting of the Am. Soc. Med. Oncol. Abstr. 1032: 2009. Go to original source...
  53. Breast Cancer Facts Figures. www.Cancer.org. 2008.
  54. Burstein H, Kuter I, Campos SM, et al. Clinical activity of trastuzumab and vinorelbine in women with HER2-overexpressing metastatic breast cancer. J Clin Oncol 2001; 19: 2722-2730. Go to original source... Go to PubMed...
  55. Hurria A, Leung D, Trainor K, et al. Factors influencing treatment patterns of breast cancer patients age 75 and older. Crit Rev Oncol Hematol 2003; 46: 121-126. Go to original source... Go to PubMed...
  56. Ingle JN. Endocrine therapy trials of aromatase inhibitors for breast cancer in the adjuvant and prevention settings. Clin Cancer Res 2005; 11: 900-905. Go to original source...
  57. Del Mastro L, Perrone F, Repetto L, et al. Weekly paclitaxel as first-line chemotherapy in elderly advanced breast cancer patients: a phase II study of the Gruppo Italiano di Oncologia Geriatrica (GIOGer). Ann Oncol 2005; 16: 253-258. Go to original source... Go to PubMed...
  58. Muss HB, Berry DA, Cirincione CT, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009; 360: 2055-2065. Go to original source... Go to PubMed...
  59. Pivot X, et al. Clinical benefit of bevacizumab +first line docetaxel in patients with locally recurrent or metastatic breast cancer: AVADO study annual meeting of the Am. Soc. Med. Oncol. Abstr. 1994: 2009. Go to original source...
  60. Seidman AD, Berry D, Cirrincione C, et al. CALGB 9840: phase III study of weekly (W) paclitaxel (P) via 1-hour (h) infusion versus standard (S) 3h infusion every third week in the treatment of metastatic breast cancer (MBC), with trastuzumab (T) for HER2 positive MBC and randomized for T in HER2 normal MBC. J Clin Oncol 2004; 22: 512. Go to original source...
  61. Sledge GW Jr. Gemcitabine combined with paclitaxel or paclitaxel/trastuzumab in metastatic breast cancer. Semin Oncol 2003; 30(suppl 3): 19-21. Go to original source... Go to PubMed...
  62. Cohen MH, Williams GA, Sridhara R, Chen G, Pazdur R. FDA approval summary: gefitinib (ZD1839) (IRESSA) tablets. Oncologist 2003; 8: 303-306. Go to original source... Go to PubMed...
  63. Johnson BE, Lucca J, Rabin MS, et al. A phase II trial of erlotinib in previously untreated elderly patients (70 years) with advanced NSCLC: Preliminary results. Ann Oncol 15: iii169, 2004; (suppl 3; abstr 639PD).




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