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Treatment Decisions and Medical Treatment of Cancer in Elderly Patients

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Drug Therapy for the Elderly

Abstract

The current demographic changes will result in an increasing number of older people. Aging is the single most important risk factor for the development of cancer. The incidence and mortality rates of most malignant disorders increase substantially with increase in age. Both developments combined result in an increasing number of elderly cancer patients (Smith et al. 2009).

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References

  • Aapro MS, Link H (2008) September 2007 update on EORTC guidelines and anemia management with erythropoiesis-stimulating agents. Oncologist 13(Suppl 3):33–36

    Article  PubMed  CAS  Google Scholar 

  • Aapro MS, Cameron DA, Pettengell R et al (2006) EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphomas and solid tumours. Eur J Cancer 42:2433–2453

    Article  PubMed  CAS  Google Scholar 

  • Amado RG, Wolf M, Peeters M et al (2008) Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol 26:1626–1634

    Article  PubMed  CAS  Google Scholar 

  • Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351

    Article  PubMed  CAS  Google Scholar 

  • Ayanian JZ, Zaslavsky AM, Fuchs CS et al (2003) Use of adjuvant chemotherapy and radiation therapy for colorectal cancer in a population-based cohort. J Clin Oncol 21:1293–1300

    Article  PubMed  Google Scholar 

  • Begg CB, Carbone PP (1983) Clinical trials and drug toxicity in the elderly. The experience of the Eastern Cooperative Oncology Group. Cancer 52:1986–1992

    Article  PubMed  CAS  Google Scholar 

  • Bliss JM, Kilburn LS, Coleman RE et al (2012) Disease-related outcomes with long-term follow-up: an updated analysis of the Intergroup Exemestane Study. J Clin Oncol 30(7):709–717

    Article  PubMed  CAS  Google Scholar 

  • Bokemeyer C, Aapro MS, Courdi A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270

    Article  PubMed  CAS  Google Scholar 

  • Bonadonna G, Valagussa P (1981) Dose–response effect of adjuvant chemotherapy in breast cancer. N Engl J Med 304:10–15

    Article  PubMed  CAS  Google Scholar 

  • Bonneterre J, Thurlimann B, Robertson JF et al (2000) Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. J Clin Oncol 18:3748–3757

    PubMed  CAS  Google Scholar 

  • Borkowski JM, Duerr M, Donehower RC et al (1994) Relation between age and clearance rate of nine investigational anticancer drugs from phase I pharmacokinetic data. Cancer Chemother Pharmacol 33:493–496

    Article  PubMed  CAS  Google Scholar 

  • Bouchardy C, Rapiti E, Blagojevic S et al (2007) Older female cancer patients: importance, causes, and consequences of undertreatment. J Clin Oncol 25:1858–1869

    Article  PubMed  Google Scholar 

  • Buccheri G, Ferrigno D, Tamburini M (1996) Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer 32A:1135–1141

    Article  PubMed  CAS  Google Scholar 

  • Cameron D, Casey M, Press M et al (2008) A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses. Breast Cancer Res Treat 112:533–543

    Article  PubMed  CAS  Google Scholar 

  • Chapman JA, Meng D, Shepherd L et al (2008) Competing causes of death from a randomized trial of extended adjuvant endocrine therapy for breast cancer. J Natl Cancer Inst 100:252–260

    Article  PubMed  Google Scholar 

  • Christman K, Muss HB, Case LD et al (1992) Chemotherapy of metastatic breast cancer in the elderly. The Piedmont Oncology Association experience. JAMA 268:57–62

    Article  PubMed  CAS  Google Scholar 

  • Coates AS, Keshaviah A, Thurlimann B et al (2007) Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Oncol 25:486–492

    Article  PubMed  CAS  Google Scholar 

  • Colleoni M, Price KN, Castiglione-Gertsch M et al (1999) Mortality during adjuvant treatment of early breast cancer with cyclophosphamide, methotrexate, and fluorouracil. International Breast Cancer Study Group. Lancet 354(9173):130–131

    Article  PubMed  CAS  Google Scholar 

  • Crivellari D, Bonetti M, Castiglione-Gertsch M et al (2000) Burdens and benefits of adjuvant cyclophosphamide, methotrexate, and fluorouracil and tamoxifen for elderly patients with breast cancer: the International Breast Cancer Study Group Trial VII. J Clin Oncol 18:1412–1422

    PubMed  CAS  Google Scholar 

  • Crivellari D, Sun Z, Coates AS et al (2008) Letrozole compared with tamoxifen for elderly patients with endocrine-responsive early breast cancer: the BIG 1-98 trial. J Clin Oncol 26:1972–1979

    Article  PubMed  CAS  Google Scholar 

  • Cronin DP, Harlan LC, Potosky AL et al (2006) Patterns of care for adjuvant therapy in a random population-based sample of patients diagnosed with colorectal cancer. Am J Gastroenterol 101:2308–2318

    Article  PubMed  CAS  Google Scholar 

  • Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20

    Article  PubMed  CAS  Google Scholar 

  • De Boer MF, Ryckman RM, Pruyn JF et al (1999) Psychosocial correlates of cancer relapse and survival: a literature review. Patient Educ Couns 37:215–230

    Article  PubMed  Google Scholar 

  • Droz JP, Balducci L, Bolla M et al (2010) Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int 106:462–469

    Article  PubMed  Google Scholar 

  • Early Breast Cancer Trialists’ Collaborative Group (2012) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 379(9814):432–444

    Google Scholar 

  • Early Breast Cancer Trialists' Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15 years survival: an overview of the randomised trials. Lancet 365 (9472): 1687–1717

    Google Scholar 

  • Edwards BK, Brown LM, Wingo PA et al (2005) Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 97:1407–1427

    Article  PubMed  Google Scholar 

  • Eichhorst B, Goede V, Hallek M (2009) Treatment of elderly patients with chronic lymphocytic leukemia. Leuk Lymphoma 50:171–178

    Article  PubMed  CAS  Google Scholar 

  • Eichhorst BF, Busch R, Stilgenbauer S et al (2009) First-line therapy with fludarabine compared with chlorambucil does not result in a major benefit for elderly patients with advanced chronic lymphocytic leukemia. Blood 114:3382–3391

    Article  PubMed  CAS  Google Scholar 

  • Elkin EB, Hurria A, Mitra N et al (2006) Adjuvant chemotherapy and survival in older women with hormone receptor-negative breast cancer: assessing outcome in a population-based, observational cohort. J Clin Oncol 24:2757–2764

    Article  PubMed  Google Scholar 

  • Endres HG, Wedding U, Pittrow D et al (2009) Prevalence of anemia in elderly patients in primary care: impact on 5-year mortality risk and differences between men and women. Curr Med Res Opin 25:1143–1158

    Article  PubMed  Google Scholar 

  • Ewer MS, O’Shaughnessy JA (2007) Cardiac toxicity of trastuzumab-related regimens in HER2-overexpressing breast cancer. Clin Breast Cancer 7:600–607

    Article  PubMed  CAS  Google Scholar 

  • Extermann M, Hurria A (2007) Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 25:1824–1831

    Article  PubMed  Google Scholar 

  • Extermann M, Overcash J, Lyman GH et al (1998) Comorbidity and functional status are independent in older cancer patients. J Clin Oncol 16:1582–1587

    PubMed  CAS  Google Scholar 

  • Extermann M, Meyer J, McGinnis M et al (2004) A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Crit Rev Oncol Hematol 49:69–75

    Article  PubMed  Google Scholar 

  • Extermann M, Boler I, Reich RR et al (2012) Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer 118:3377–3386

    Google Scholar 

  • Facon T, Mary JY, Hulin C et al (2007) Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet 370(9594):1209–1218

    Article  PubMed  CAS  Google Scholar 

  • Fenaux P, Mufti GJ, Hellstrom-Lindberg E et al (2009) Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol 10:223–232

    Article  PubMed  CAS  Google Scholar 

  • Fenaux P, Mufti GJ, Hellstrom-Lindberg E et al (2009) Azacitidine prolongs overall survival compared with conventional care regimens in elderly patients with low bone marrow blast count acute myeloid leukemia. J Clin Oncol 28:562–569

    Article  PubMed  CAS  Google Scholar 

  • Forbes JF, Cuzick J, Buzdar A et al (2008) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol 9:45–53

    Article  PubMed  CAS  Google Scholar 

  • Fossati R, Confalonieri C, Torri V et al (1998) Cytotoxic and hormonal treatment for metastatic breast cancer: a systematic review of published randomized trials involving 31,510 women. J Clin Oncol 16:3439–3460

    PubMed  CAS  Google Scholar 

  • Frasci G, Lorusso V, Panza N et al (2000) Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small-cell lung cancer. J Clin Oncol 18:2529–2536

    PubMed  CAS  Google Scholar 

  • Freyer G, Geay JF, Touzet S et al (2005) Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: a GINECO study. Ann Oncol 16:1795–1800

    Article  PubMed  CAS  Google Scholar 

  • Fruh M, Rolland E, Pignon JP et al (2008) Pooled analysis of the effect of age on adjuvant cisplatin-based chemotherapy for completely resected non-small-cell lung cancer. J Clin Oncol 26:3573–3581

    Article  PubMed  CAS  Google Scholar 

  • Gelman RS, Taylor SGT (1984) Cyclophosphamide, methotrexate, and 5-fluorouracil chemotherapy in women more than 65 years old with advanced breast cancer: the elimination of age trends in toxicity by using doses based on creatinine clearance. J Clin Oncol 2:1404–1413

    PubMed  CAS  Google Scholar 

  • Geyer CE, Forster J, Lindquist D et al (2006) Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 355:2733–2743

    Article  PubMed  CAS  Google Scholar 

  • Giordano SH, Duan Z, Kuo YF et al (2006) Use and outcomes of adjuvant chemotherapy in older women with breast cancer. J Clin Oncol 24:2750–2756

    Article  PubMed  Google Scholar 

  • Giovanazzi-Bannon S, Rademaker A, Lai G et al (1994) Treatment tolerance of elderly cancer patients entered onto phase II clinical trials: an Illinois Cancer Center study. J Clin Oncol 12:2447–2452

    PubMed  CAS  Google Scholar 

  • Girre V, Falcou MC, Gisselbrecht M et al (2008) Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients? J Gerontol A Biol Sci Med Sci 63:724–730

    Article  PubMed  Google Scholar 

  • Goldhirsch A, Castiglione M, Gelber RD (1990) Adjuvant chemo-endocrine therapy in postmenopausal women with breast cancer and axillary-node metastases. Lancet 335(8697):1099–1100

    Article  PubMed  CAS  Google Scholar 

  • Goldhirsch A, Coates AS, Gelber RD et al (2006) First—select the target: better choice of adjuvant treatments for breast cancer patients. Ann Oncol 17:1772–1776

    Article  PubMed  CAS  Google Scholar 

  • Goldhirsch A, Wood WC, Gelber RD et al (2007) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol 18:1133–1144

    Article  PubMed  CAS  Google Scholar 

  • Goldstone AH, Burnett AK, Wheatley K et al (2001) Attempts to improve treatment outcomes in acute myeloid leukemia (AML) in older patients: the results of the United Kingdom Medical Research Council AML11 trial. Blood 98:1302–1311

    Article  PubMed  CAS  Google Scholar 

  • Goodwin JS, Samet JM, Key CR et al (1986) Stage at diagnosis of cancer varies with the age of the patient. J Am Geriatr Soc 34:20–26

    PubMed  CAS  Google Scholar 

  • Hallek M, Fischer K, Fingerle-Rowson G et al (2010) Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomised, open-label, phase 3 trial. Lancet 376(9747):1164–1174

    Article  PubMed  CAS  Google Scholar 

  • Haller DG, Catalano PJ, Macdonald JS et al (2005) Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol 23:8671–8678

    Article  PubMed  Google Scholar 

  • Haller DG, Tabernero J, Maroun J et al (2011) Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol 29:1465–1471

    Article  PubMed  CAS  Google Scholar 

  • Harter P, du Bois A, Schade-Brittinger C et al (2005) Non-enrolment of ovarian cancer patients in clinical trials: reasons and background. Ann Oncol 16:1801–1805

    Article  PubMed  CAS  Google Scholar 

  • Honecker FU, Wedding U, Rettig K et al (2009) Use of the Comprehensive Geriatric Assessment (CGA) in elderly patients with solid tumors to predict mortality. J Clin Oncol 27(15s):9549

    Google Scholar 

  • Hughes KS, Schnaper LA, Berry D et al (2004) Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 351:971–977

    Article  PubMed  CAS  Google Scholar 

  • Hulin C, Facon T, Rodon P et al (2009) Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial. J Clin Oncol 27:3664–3670

    Article  PubMed  CAS  Google Scholar 

  • Hurria A, Balducci L (eds) (2009) Geriatric oncology. Springer, Heidelberg

    Google Scholar 

  • Hurria A, Togawa K, Mohile SG et al (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29:3457–3465

    Article  PubMed  CAS  Google Scholar 

  • Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342

    Article  PubMed  CAS  Google Scholar 

  • Hutchins LF, Unger JM, Crowley JJ et al (1999) Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 341:2061–2067

    Article  PubMed  CAS  Google Scholar 

  • Jakesz R, Greil R, Gnant M et al (2007) Extended adjuvant therapy with anastrozole among postmenopausal breast cancer patients: results from the randomized Austrian Breast and Colorectal Cancer Study Group Trial 6a. J Natl Cancer Inst 99:1845–1853

    Article  PubMed  CAS  Google Scholar 

  • Jin H, Tu D, Zhao N et al (2012) Longer-term outcomes of letrozole versus placebo after 5 years of tamoxifen in the NCIC CTG MA.17 trial: analyses adjusting for treatment crossover. J Clin Oncol 30(7):718–721

    Article  PubMed  CAS  Google Scholar 

  • Joensuu H, Kellokumpu-Lehtinen PL, Bono P et al (2006) Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med 354:809–820

    Article  PubMed  CAS  Google Scholar 

  • Kabbinavar FF, Schulz J, McCleod M et al (2005) Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase II trial. J Clin Oncol 23:3697–3705

    Article  PubMed  CAS  Google Scholar 

  • Kabbinavar FF, Hurwitz HI, Yi J et al (2009) Addition of bevacizumab to fluorouracil-based first-line treatment of metastatic colorectal cancer: pooled analysis of cohorts of older patients from two randomized clinical trials. J Clin Oncol 27:199–205

    Article  PubMed  CAS  Google Scholar 

  • Karnofsky DA, Adelmann WH, Craver FL (1948) The use of nitrogen mustard in the palliative treatment of carcinoma. Cancer 1:634–656

    Article  Google Scholar 

  • Kaufmann M, Jonat W, Hilfrich J et al (2007) Improved overall survival in postmenopausal women with early breast cancer after anastrozole initiated after treatment with tamoxifen compared with continued tamoxifen: the ARNO 95 Study. J Clin Oncol 25:2664–2670

    Article  PubMed  CAS  Google Scholar 

  • Keating NL, Landrum MB, Klabunde CN et al (2008) Adjuvant chemotherapy for stage III colon cancer: do physicians agree about the importance of patient age and comorbidity? J Clin Oncol 26:2532–2537

    Article  PubMed  Google Scholar 

  • Kemeny MM, Peterson BL, Kornblith AB et al (2003) Barriers to clinical trial participation by older women with breast cancer. J Clin Oncol 21:2268–2275

    Article  PubMed  Google Scholar 

  • Knauf WU, Lissichkov T, Aldaoud A et al (2009) Phase III randomized study of bendamustine compared with chlorambucil in previously untreated patients with chronic lymphocytic leukemia. J Clin Oncol 27:4378–4384

    Article  PubMed  CAS  Google Scholar 

  • Kohne CH, Folprecht G, Goldberg RM et al (2008) Chemotherapy in elderly patients with colorectal cancer. Oncologist 13:390–402

    Article  PubMed  CAS  Google Scholar 

  • Kudoh S, Takeda K, Nakagawa K et al (2006) Phase III study of docetaxel compared with vinorelbine in elderly patients with advanced non-small-cell lung cancer: results of the West Japan Thoracic Oncology Group Trial (WJTOG 9904). J Clin Oncol 24:3657–3663

    Article  PubMed  CAS  Google Scholar 

  • Lees J, Chan A (2011) Polypharmacy in elderly patients with cancer: clinical implications and management. Lancet Oncol 12:1249–1257

    Article  PubMed  Google Scholar 

  • Lewis JH, Kilgore ML, Goldman DP et al (2003) Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 21:1383–1389

    Article  PubMed  Google Scholar 

  • Lievre A, Bachet JB, Boige V et al (2008) KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab. J Clin Oncol 26:374–379

    Article  PubMed  CAS  Google Scholar 

  • Lynch TJ, Bell DW, Sordella R et al (2004) Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 350:2129–2139

    Article  PubMed  CAS  Google Scholar 

  • Mamounas EP, Jeong JH, Wickerham DL et al (2008) Benefit from exemestane as extended adjuvant therapy after 5 years of adjuvant tamoxifen: intention-to-treat analysis of the National Surgical Adjuvant Breast and Bowel Project B-33 trial. J Clin Oncol 26:1965–1971

    Article  PubMed  CAS  Google Scholar 

  • Massie MJ (2004) Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57–71

    Article  PubMed  Google Scholar 

  • McCleary NAJ, Meyerhardt J, Green E et al (2009) Impact of older age on the efficacy of newer adjuvant therapies in >12,500 patients with stage II/III colon cancer: findings from the ACCENT Database. J Clin Oncol 27:15s (suppl; abstr 4010)

    Article  Google Scholar 

  • Monfardini S, Sorio R, Kaye S (1994) Should elderly cancer patients be entered in dose-escalation studies? Ann Oncol 5:964–965

    PubMed  CAS  Google Scholar 

  • Mor V, Laliberte L, Morris JN et al (1984) The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer 53:2002–2007

    Article  PubMed  CAS  Google Scholar 

  • Muss HB, Woolf S, Berry D et al (2005) Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA 293:1073–1081

    Article  PubMed  CAS  Google Scholar 

  • Muss HB, Berry DA, Cirrincione CT et al (2009) Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 360:2055–2065

    Article  PubMed  CAS  Google Scholar 

  • Neugut AI, Fleischauer AT, Sundararajan V et al (2002) Use of adjuvant chemotherapy and radiation therapy for rectal cancer among the elderly: a population-based study. J Clin Oncol 20:2643–2650

    Article  PubMed  Google Scholar 

  • Osborne CK, Pippen J, Jones SE et al (2002) Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial. J Clin Oncol 20:3386–3395

    Article  PubMed  CAS  Google Scholar 

  • Pallis AG, Gridelli C, van Meerbeeck JP et al (2009) EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts’ opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Oncol 21:692–706

    Article  PubMed  Google Scholar 

  • Palumbo A, Bringhen S, Ludwig H et al (2011) Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN). Blood 118:4519–4529

    Article  PubMed  CAS  Google Scholar 

  • Piccart-Gebhart MJ, Procter M, Leyland-Jones B et al (2005) Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 353:1659–1672

    Article  PubMed  CAS  Google Scholar 

  • Pignon JP, Tribodet H, Scagliotti GV et al (2008) Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol 26:3552–3559

    Article  PubMed  Google Scholar 

  • Pinder MC, Duan Z, Goodwin JS et al (2007) Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol 25:3808–3815

    Article  PubMed  CAS  Google Scholar 

  • Quoix E, Zalcman G, Oster JP et al (2011) Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet 378(9796):1079–1088

    Article  PubMed  CAS  Google Scholar 

  • Rao AV, Hsieh F, Feussner JR et al (2005) Geriatric evaluation and management units in the care of the frail elderly cancer patient. J Gerontol A Biol Sci Med Sci 60:798–803

    Article  PubMed  Google Scholar 

  • Read WL, Tierney RM, Page NC et al (2004) Differential prognostic impact of comorbidity. J Clin Oncol 22:3099–3103

    Article  PubMed  Google Scholar 

  • Regan MM, Neven P, Giobbie-Hurder A et al (2011) Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer: the BIG 1-98 randomised clinical trial at 8.1 years median follow-up. Lancet Oncol 12:1101–1108

    Article  PubMed  CAS  Google Scholar 

  • Rehse B, Pukrop R (2003) Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies. Patient Educ Couns 50:179–186

    Article  PubMed  Google Scholar 

  • Repetto L, Venturino A, Vercelli M et al (1998) Performance status and comorbidity in elderly cancer patients compared with young patients with neoplasia and elderly patients without neoplastic conditions. Cancer 82:760–765

    Article  PubMed  CAS  Google Scholar 

  • Repetto L, Carreca I, Maraninchi D et al (2003) Use of growth factors in the elderly patient with cancer: a report from the Second International Society for Geriatric Oncology (SIOG) 2001 meeting. Crit Rev Oncol Hematol 45:123–128

    Article  PubMed  Google Scholar 

  • Romond EH, Perez EA, Bryant J et al (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353:1673–1684

    Article  PubMed  CAS  Google Scholar 

  • Samet J, Hunt WC, Key C et al (1986) Choice of cancer therapy varies with age of patient. JAMA 255:3385–3390

    Article  PubMed  CAS  Google Scholar 

  • San Miguel JF, Schlag R, Khuageva NK et al (2008) Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med 359:906–917

    Article  PubMed  CAS  Google Scholar 

  • Sargent DJ, Goldberg RM, Jacobson SD et al (2001) A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 345:1091–1097

    Article  PubMed  CAS  Google Scholar 

  • Sargent DJ, Wieand HS, Haller DG et al (2005) Disease-free survival versus overall survival as a primary end point for adjuvant colon cancer studies: individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol 23:8664–8670

    Article  PubMed  Google Scholar 

  • Sargent DJ, Kohne CH, Sanoff HK et al (2009) Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer. J Clin Oncol 27:1948–1955

    Article  PubMed  Google Scholar 

  • Schairer C, Mink PJ, Carroll L et al (2004) Probabilities of death from breast cancer and other causes among female breast cancer patients. J Natl Cancer Inst 96:1311–1321

    Article  PubMed  Google Scholar 

  • Seymour JF, Fenaux P, Silverman LR et al (2010) Effects of azacitidine compared with conventional care regimens in elderly (≥75 years) patients with higher-risk myelodysplastic syndromes. Crit Rev Oncol Hematol 76:218–227

    Article  PubMed  Google Scholar 

  • Slamon DJ, Leyland-Jones B, Shak S et al (2001) Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 344:783–792

    Article  PubMed  CAS  Google Scholar 

  • Slamon D, Eiermann W, Robert N et al (2011) Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med 365:1273–1283

    Article  PubMed  CAS  Google Scholar 

  • Smith BD, Smith GL, Hurria A et al (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765

    Article  PubMed  Google Scholar 

  • Sperr WR, Wimazal F, Kundi M et al (2010) Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group. Ann Oncol 21:114–119

    Article  PubMed  CAS  Google Scholar 

  • Stein BN, Petrelli NJ, Douglass HO et al (1995) Age and sex are independent predictors of 5-fluorouracil toxicity. Analysis of a large scale phase III trial. Cancer 75:11–17

    Article  PubMed  CAS  Google Scholar 

  • Stuck AE, Siu AL, Wieland GD et al (1993) Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 342(8878):1032–1036

    Article  PubMed  CAS  Google Scholar 

  • Sundararajan V, Mitra N, Jacobson JS et al (2002) Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Intern Med 136:349–357

    PubMed  CAS  Google Scholar 

  • Tanne JH (2011) FDA cancels approval for bevacizumab in advanced breast cancer. BMJ 343:d7684

    Article  PubMed  Google Scholar 

  • The Elderly Lung Cancer Vinorelbine Italian Study Group (1999) Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. J Natl Cancer Inst 91:66–72

    Article  Google Scholar 

  • Thomas XG, Dmoszynska A, Wierzbowska A et al (2011) Results from a randomized phase III trial of decitabine versus supportive care or low-dose cytarabine for the treatment of older patients with newly diagnosed AML. J Clin Oncol 29:6509

    Article  Google Scholar 

  • Tol J, Koopman M, Cats A et al (2009) Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer. N Engl J Med 360:563–572

    Article  PubMed  CAS  Google Scholar 

  • Trimble EL, Carter CL, Cain D et al (1994) Representation of older patients in cancer treatment trials. Cancer 74(7 Suppl):2208–2214

    Article  PubMed  CAS  Google Scholar 

  • Turner NJ, Haward RA, Mulley GP et al (1999) Cancer in old age—is it inadequately investigated and treated? BMJ 319(7205):309–312

    Article  PubMed  CAS  Google Scholar 

  • Twelves C, Wong A, Nowacki MP et al (2005) Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 352:2696–2704

    Article  PubMed  CAS  Google Scholar 

  • Van Cutsem E, Kohne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417

    Article  PubMed  Google Scholar 

  • Wagner AD, Wedding U (2009) Advances in the pharmacological treatment of gastro-oesophageal cancer. Drugs Aging 26:627–646

    Article  PubMed  CAS  Google Scholar 

  • Watson M, McCarron J, Law M (1992) Anticipatory nausea and emesis, and psychological morbidity: assessment of prevalence among out-patients on mild to moderate chemotherapy regimens. Br J Cancer 66:862–866

    Article  PubMed  CAS  Google Scholar 

  • Wedding U, Honecker F, Bokemeyer C et al (2007) Tolerance to chemotherapy in elderly patients with cancer. Cancer Control 14:44–56

    PubMed  Google Scholar 

  • Wedding U, Rohrig B, Klippstein A et al (2007) Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients. J Cancer Res Clin Oncol 133:945–950

    Article  PubMed  Google Scholar 

  • Wedding U, Rohrig B, Pientka L et al (2007) Anaemia-related impairment in quality of life in elderly cancer patients prior to chemotherapy. J Cancer Res Clin Oncol 133:279–286

    Article  PubMed  Google Scholar 

  • Wehling M (2009) Multimorbidity and polypharmacy: how to reduce the harmful drug load and yet add needed drugs in the elderly? Proposal of a new drug classification: fit for the aged. J Am Geriatr Soc 57:560–561

    Article  PubMed  Google Scholar 

  • Xu J, Kochanek K, Murphy SL, Tejada-Vera B (2010) Deaths: final data for 2007. National Vital Statistics Reports, 58(19). http://www.cdc.gov/NCHS/data/nvsr/nvsr58/nvsr58_19.pdf. Accessed 17 Jan 2012

  • Zhou C, Wu YL, Chen G et al (2011) Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 12:735–742

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinic for Internal Medicine II, Division of Palliative Care, University Clinics Jena, Erlanger Allee 101, 07740, Jena, Germany

    Ulrich Wedding

  2. 65+ Clinical Geriatric Program, Memorial Sloan-Kettering Cancer Center, 650 Commack Road, Commack, NY, 11725, USA

    Stuart M. Lichtman

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  1. Ulrich Wedding
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  2. Stuart M. Lichtman
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Correspondence to Ulrich Wedding .

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Editors and Affiliations

  1. Inst. Klinische Pharmakologie, Klinikum Stadt Mannheim gGmbH, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany

    Martin Wehling

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Wedding, U., Lichtman, S.M. (2013). Treatment Decisions and Medical Treatment of Cancer in Elderly Patients. In: Wehling, M. (eds) Drug Therapy for the Elderly. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0912-0_18

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