TRATTAMENTO DEL NSCLC AVANZATO NELL'ANZIANO D. Giardina, F. Artioli Vol.1 (2017), issue 3, pag. 1-11
Accepted for pubblication
The incidence of cancer increases by age; neoplastic disease management in elderly patients requires a multi-dimensional approach. Lung cancer is a common cancer in old age. In fact over 50% of patients with lung cancer are over 65 years and about 30% have more than 70 years. Our article aims to identify the optimal management of elderly patients with Non Small Cell Lung cancer (NSCLC) including the choice of chemotherapy, the role of new drugs (targeted therapies, immunotherapy) and the importance of supportive care.
Purpose. To summarize current data on the treatment and management of advanced NSCLC in elderly patients. Methods
We analyzed the scienti c literature on the treatment of advanced NSCLC (stage IIIB and IV) in the last 20 years, through a MEDLINE search strategy based on the following key words: non-small cell lung cancer, elderly, management. Conclusions
Monochemotherapy third-generation drug-based is the recommended treatment for elderly patients (age> 70 years) with NSCLC stage IIIB-IV in the current clinical practice. Chemotherapy including third- generation platinum-based regimen with reduced dose is a valid therapeutic option alternative to single-agent chemotherapy in patients with good performance status (PS 0-1) and adequate organ function. In patients with age> 80 years the bene t of chemotherapy is not clear and the choice to treat or not with single-agent chemotherapy will be on individual basis. Finally supportive therapy should be introduced as early treatment of cancer symptoms as it has a positive impact on both quality of life and survival.For elderly patients (age> 70 years) with NSCLC stage IIIB-IV mutated EGFR, ge tinib is the recommended treatment.