Journal ArticleDOI
International Society of Geriatric Oncology Chemotherapy Taskforce: Evaluation of Chemotherapy in Older Patients—An Analysis of the Medical Literature
Stuart M. Lichtman,Hans Wildiers,Etienne Chatelut,Christopher Steer,Daniel R. Budman,Vicki A. Morrison,Brigitte Tranchand,Iuliana Shapira,Matti S. Aapro +8 more
TLDR
Clinical trials need to incorporate an analysis of chemotherapy in terms of the pharmacokinetic and pharmacodynamic effects of aging, and data already accumulated need to be reanalyzed by age to aid in the management of the older cancer patient.Abstract:
The elderly comprise the majority of patients with cancer and are the recipients of the greatest amount of chemotherapy. Unfortunately, there is a lack of data to make evidence-based decisions with regard to chemotherapy. This is due to the minimal participation of older patients in clinical trials and that trials have not systematically evaluated chemotherapy. This article reviews the available information with regard to chemotherapy and aging provided by a task force of the International Society of Geriatric Oncology (SIOG). Due to the lack of prospective data, the conclusions and recommendations made are a consensus of the participants. Extrapolation of data from younger to older patients is necessary, particularly to those patients older than 80 years, for which data is almost entirely lacking. The classes of drugs reviewed include alkylators, antimetabolites, anthracyclines, taxanes, camptothecins, and epipodophyllotoxins. Clinical trials need to incorporate an analysis of chemotherapy in terms of the pharmacokinetic and pharmacodynamic effects of aging. In addition, data already accumulated need to be reanalyzed by age to aid in the management of the older cancer patient.read more
Citations
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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines
TL;DR: Lymphedema is a common complication after treatment for breast cancer and factors associated with increased risk of lymphedEMA include extent of axillary surgery, axillary radiation, infection, and patient obesity.
Journal ArticleDOI
Appropriate Chemotherapy Dosing for Obese Adult Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline
Jennifer J. Griggs,Pamela B. Mangu,Holly Anderson,Edward P. Balaban,James J. Dignam,William Hryniuk,Vicki A. Morrison,T. May Pini,Carolyn D. Runowicz,Gary L. Rosner,Michelle Shayne,Alex Sparreboom,Lara Sucheston,Gary H. Lyman +13 more
TL;DR: Full weight-based cytotoxic chemotherapy doses be used to treat obese patients with cancer, particularly when the goal of treatment is cure, and the use of fixed-dose chemotherapy is rarely justified.
Journal ArticleDOI
Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology
Hans Wildiers,Ian Kunkler,Laura Biganzoli,Jacques Fracheboud,George Vlastos,Chantal Bernard-Marty,Arti Hurria,Martine Extermann,Véronique Girre,Etienne Brain,Riccardo A. Audisio,Harry Bartelink,Mary B Barton,Sharon H. Giordano,Hyman B. Muss,Matti Aapro +15 more
TL;DR: The available evidence was reviewed and synthesised to provide consensus recommendations regarding the care of breast cancer in older adults and recommendations are given on the topics of screening, surgery, radiotherapy, (neo)adjuvant hormone treatment and chemotherapy, and metastatic disease.
Journal ArticleDOI
EORTC elderly task force position paper: Approach to the older cancer patient
Athanasios G. Pallis,Catherine Fortpied,Ulrich Wedding,M C Van Nes,Bjorn Penninckx,Alistair Ring,Denis Lacombe,Silvio Monfardini,Pierre Scalliet,Hans Wildiers +9 more
TL;DR: The purpose of this paper is to focus on the influence of age on cancer presentation and cancer management in older cancer patients and to provide suggestions on clinical trial development and methodology in this population.
Journal ArticleDOI
The effect of age and gender on bladder cancer: a critical review of the literature.
Shahrokh F. Shariat,John P. Sfakianos,John P. Sfakianos,Michael J. Droller,Pierre I. Karakiewicz,Siegfried Meryn,Bernard H. Bochner +6 more
TL;DR: While men are three to four times more likely to develop UCB than women, women present with more advanced disease and have worse survival rates, and Epidemiological and mechanistic molecular studies should be encouraged to design, analyse and report gender‐ and age‐specific associations.
References
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Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer
Ian F. Tannock,Ronald de Wit,William R. Berry,Jozsef Horti,Anna Pluzanska,Kim N. Chi,Stéphane Oudard,Christine Theodore,Nicholas D. James,Ingela Turesson,Mark Rosenthal,Mario A. Eisenberger +11 more
TL;DR: When given with prednisone, treatment with docetaxel every three weeks led to superior survival and improved rates of response in terms of pain, serum PSA level, and quality of life, as compared with mitoxantrone plusprednisone.
Journal ArticleDOI
Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate.
Andrew S. Levey,Josef Coresh,Tom Greene,Lesley A. Stevens,Yaping (Lucy) Zhang,Stephen Hendriksen,John W. Kusek,Frederick Van Lente +7 more
TL;DR: The MDRD Study equation has now been reexpressed for use with a standardized serum creatinine assay, allowing GFR estimates to be reported in clinical practice by using standardized serumcreatinine and overcoming this limitation to the current use of GFR estimating equations.
Journal ArticleDOI
Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)
Andrew S. Levey,Kai-Uwe Eckardt,Yusuke Tsukamoto,Adeera Levin,Josef Coresh,Jerome Rossert,Dick de Zeeuw,Thomas H. Hostetter,Norbert Lameire,Garabed Eknoyan +9 more
TL;DR: A survey and conference was conducted and a controversies conference was sponsored to provide a clear understanding to both the nephrology and nonnephrology communities of the evidence base for the definition and classification recommended by Kidney Disease Quality Outcome Initiative (K/DOQI).
Journal ArticleDOI
Randomized Phase III Trial of Pemetrexed Versus Docetaxel in Patients With Non–Small-Cell Lung Cancer Previously Treated With Chemotherapy
Nasser H. Hanna,Frances A. Shepherd,Frank V. Fossella,José Rodrigues Pereira,Filippo de Marinis,Joachim von Pawel,Ulrich Gatzemeier,Thomas Chang Yao Tsao,Miklos Pless,Thomas Müller,Hong-Liang Lim,Christopher Desch,Klara Szondy,Radj Gervais,Shaharyar,Christian Manegold,Sofia Paul,Paolo Paoletti,Lawrence H. Einhorn,Paul A. Bunn +19 more
TL;DR: Treatment with pemetrexed resulted in clinically equivalent efficacy outcomes, but with significantly fewer side effects compared with docetaxel in the second-line treatment of patients with advanced NSCLC and should be considered a standard treatment option for second-liners when available.
Journal ArticleDOI
Underrepresentation of patients 65 years of age or older in cancer-treatment trials.
TL;DR: There is substantial under representation of patients 65 years of age or older in studies of treatment for cancer, and the reasons should be clarified, and policies adopted to correct this underrepresentation.