Targeted therapy and elderly people: A review

Eur J Cancer. 2016 Dec:69:199-215. doi: 10.1016/j.ejca.2016.10.005. Epub 2016 Nov 15.

Abstract

The use of targeted therapy (TT) has radically changed the outcome of various cancers and introduces the era of personalised medicine. Elderly patients (≥65 years) represent the majority of cancer diagnoses and deaths by age group with an increase expected over the next decade. This group of patients is heterogeneous with three categories of patients: fit, vulnerable and frail, with specific treatment for each subgroup. In this review, we assess safety and efficacy of TT in elderly patients, principally from data of pivotal clinical trials with subgroup analysis, but elderly people represented a small percentage of the total number of patients. Few specific trials have been carried out for TT in elderly people with most patients considered to be fit. However, tolerance and efficacy of TT in elderly patients seems similar to that for younger patients, with an increase in incidence of specific adverse events in elderly patients for selected TTs. An adapted geriatric selection and strict monitoring could help to decrease toxicity, and specific clinical trials for elderly cancer patients would be useful.

Keywords: Adverse events; Elderly people; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anaplastic Lymphoma Kinase
  • Angiogenesis Inhibitors / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Renal Cell / drug therapy
  • Colorectal Neoplasms / drug therapy
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • ErbB Receptors / antagonists & inhibitors
  • Female
  • Gastrointestinal Stromal Tumors / drug therapy
  • Humans
  • Kidney Neoplasms / drug therapy
  • Lung Neoplasms / drug therapy
  • Male
  • Melanoma / drug therapy
  • Molecular Targeted Therapy
  • Neoplasms / drug therapy*
  • Ovarian Neoplasms / drug therapy
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors
  • Receptor Protein-Tyrosine Kinases / antagonists & inhibitors
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Skin Neoplasms / drug therapy
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Vascular Endothelial Growth Factor A
  • Anaplastic Lymphoma Kinase
  • ErbB Receptors
  • Receptor Protein-Tyrosine Kinases
  • Receptor, ErbB-2
  • Proto-Oncogene Proteins B-raf
  • TOR Serine-Threonine Kinases