Pharmacological factors influencing anticancer drug selection in the elderly.

摘要: Persons over the age of 65 years are fastest growing segment US population. In next 30 this will represent more than 20% Fifty percent all cancers occur in group and therefore total cancer burden is expected to rise. Data becoming available that better guide use chemotherapy older patient Studies presented discussing pharmacokinetic data on a number chemotherapeutic agents with an emphasis those have entered clinical practice past few years. Many these seem beneficial therapeutic index, particularly regard patients. Aging can affect pharmacokinetics ways. Absorption only modified minimally by age. The greater concern oral drugs compliance. Volume distribution affected changes body composition, anaemia decreased plasma albumin concentration. There many which renal excretion plays important role. Decline glomerular filtration consistent phenomenon aging. Drug metabolism primarily P450 system coadministration also interact enzyme system. selection elderly frequently determined degree comorbidity patients' functional status. These factors critical often determine response toxicity. This article discusses antimetabolites, camptothecins, anthracyclines, taxanes, platinum compounds, epipodophyllotoxins vinca alkaloids. has been increasing trend toward chemotherapy. Factors must be considered selecting include limitations saturability absorption, compliance pharmacodynamic Interpatient variability age-related drug discussed. Careful attention physiological dose adjustments necessary for end-organ dysfunction (renal, hepatic) needed ensure safe administration specific diseases discussed (breast, colon, ovarian non-small lung cancers) recommendations adjuvant treatment metastatic disease. Future studies need incorporate various properly evaluate Research educational initiatives targeted population priority.