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Toxicity of Cancer Therapies in Older Patients

  • Integrative Care (C Lammersfeld, Section Editor)
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Abstract

Purpose of the Review

In clinical practice, older patients are often undertreated due to underrepresentation in clinical trials and fear of toxicity. Our objective was therefore to review toxicities that are specific to older cancer patients, to review risk factors in order to help physicians guide their decisions, and to review interventions that can be implemented in routine clinical practice to prevent toxicity induced by cancer therapies.

Recent Findings

On the whole, reviews report similar number and frequency as well as similar grade 3 or 4 adverse events between subjects older and younger than 65 years.

Summary

Yet patients included in clinical trials are often not representative of real-life patients and are often fit older cancer patients. Moreover, tolerance to the additive impact of multiple adverse effects is different between older and younger patients. And specific symptoms such as stomatitis may cause a series of consequences such as dehydration, denutrition, renal insufficiency, and adverse events of renally excreted drugs. Older patients are at high risk of toxicity due to many factors but mainly due to the prevalence of frailty in this population that has been estimated to be around 40% increasing the risk of chemotherapy intolerance. As a consequence, interventions must be implemented according to altered domains of comprehensive geriatric assessment in order to improve anticancer tolerance. These interventions are reviewed here.

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Authors and Affiliations

  1. Medical Oncology Department, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    Olivia Le Saux

  2. Geriatric Oncology Department, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    Claire Falandry

  3. CarMen biomedical research laboratory (Cardiovascular diseases, Metabolism, diabetology and Nutrition) INSERM UMR 1060, Université de Lyon, Oullins, France

    Claire Falandry

Authors
  1. Olivia Le Saux
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  2. Claire Falandry
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Correspondence to Olivia Le Saux.

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Conflict of Interest

Olivia Le Saux declares that she has no conflict of interest.

Claire Falandry has received research support through grants from Novartis, Pfizer, Chugai, Astellas, and Pierre Fabre, and has received compensation from Roche, Teva, Pfizer, Chugai, Janssen, and Astellas for service as a consultant.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Integrative Care

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Le Saux, O., Falandry, C. Toxicity of Cancer Therapies in Older Patients. Curr Oncol Rep 20, 64 (2018). https://doi.org/10.1007/s11912-018-0705-y

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  • DOI: https://doi.org/10.1007/s11912-018-0705-y

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