SPECIAL ISSUE: LUNG CANCER IN ELDERLY PATIENTS - Therapeutic options in advanced NSCLC in older patients
M.C. Parati, K.F. Borgonovo
Vol.7 (2022), issue 1, pag. 44 - 68
| Received | 13/09/2021 |
| Accepted | 26/11/2021 |
| Published | 18/01/2022 |
| Review by | Double-blind |
| DOI | https://doi.org/10.48253/AGO23 |
ABSTRACT
Lung cancer is predominantly a disease of older persons. Currently median age at diagnosis is 70 years and almost 10% of patients are aged 80 or more. The increasing number of older patients is generating a social and health problem, despite that, these patients are under-represented in clinical trials and under-treated in clinical practice.
Treatment choices for advanced NSCLC are mainly guided by tumor-related characteristics; in the past years, the therapeutic landscape of NSCLC has changed impressively with the introduction of targeted therapies and immunotherapies next to chemotherapy. The main dif culty in treating older patients is to maximize the therapy bene ts and minimize the treatment risk.
Older patients are a very heterogeneous group with major differences for functional and cognitive status as well as for the presence of comorbidities and polypharmacy interactions.
All these factors may increase the risk of mortality and toxicity with cancer treatments compared to younger patients.
The choice to treat or not to treat older patients cannot be taken only on the basis of chronological age.