Clinical pharmacology of oncology agents in older adults: A comprehensive review of how chronologic and functional age can influence treatment-related effects

Journal of Geriatric Oncology
Ginah NightingalePatrick Medina

Abstract

Unique challenges exist when managing older adults with cancer. Associations between cancer and age-related physiologic changes have a direct impact on pharmacokinetics and pharmacodynamics of cancer therapies and can affect drug dosing, dose intensity, efficacy, safety and quality of life. The breadth and depth of these issues, however, have not been fully evaluated because the majority of clinical trials have focused on a younger and healthier population. As a consequence, little information is available to support clinicians in making evidence-based decisions regarding treatment with cancer therapies in older adults, especially those over age 75. Prior clinical pharmacology reviews summarized the literature on how age-related physiologic changes can influence and affect conventional and targeted anti-cancer treatments. Our article provides an updated review with expanded information that includes small molecule kinase inhibitors, monoclonal antibodies, immunotherapies, hormonal, conventional, and miscellaneous agents. Additionally, our article integrates how functional age, determined by the geriatric assessment (GA), can also influence treatment-related effects and health outcomes. Broadening cancer therapy trials to captur...Continue Reading

Citations

Aug 8, 2019·CA: a Cancer Journal for Clinicians·Carol E DeSantisRebecca L Siegel
Sep 11, 2019·American Journal of Clinical Oncology·Daniela GretoLorenzo Livi
Nov 28, 2018·Drugs & Aging·Zeina Al-MansourVenu Bathini
Jun 27, 2019·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·J FeliuM J Molina-Garrido
Dec 20, 2019·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Danielle S ChunJennifer L Lund
May 7, 2019·World Journal of Gastroenterology : WJG·Kenya KamimuraShuji Terai
May 18, 2019·American Society of Clinical Oncology Educational Book·Allison MagnusonKelly M Trevino
Jul 11, 2020·European Journal of Clinical Investigation·Domenico FuscoUNKNOWN Oncogeriatrics Group of the Italian Society of Gerontology, Geriatrics
Feb 17, 2021·Journal of Geriatric Oncology·Ginah NightingaleAndrew Chapman
Mar 12, 2021·Aging Clinical and Experimental Research·Beatrice Di CapuaGiuseppe Ferdinando Colloca

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