People aged over 65 years old are the fastest growing segment of the Australian population and represent the majority of cancer cases diagnosed. We also know that older adults receiving chemotherapy are a vulnerable group – often with decreased functional reserves, multiple co-morbidities, socioeconomic challenges and variable treatment tolerance.
Minimizing toxicity while maximizing efficacy is a common goal in the treatment of any condition but its importance is underscored in the discipline of oncology because of the serious nature of many chemotherapeutic toxicities and the risk of cancer recurrence or disease progression. The practice of dosing many chemotherapeutic agents based on body surface area is an effort to successfully balance efficacy and toxicity; however, the lack of correlation with drug exposure levels and outcomes for the majority of chemotherapeutic agents makes this method alone insufficient. This is especially important in populations in whom alteration in pharmacokinetic and other patient-specific factors may further yield increased risk of toxicity, such as those patients older than age 65 years.
However, it should be remembered that advanced age alone should not preclude the use of effective systemic anti-cancer therapies which could improve quality of life and potentially provide meaningful survival benefit. This presentation will explore the use of such treatments in the older adult and provide an overview of considerations to guide the delivery of therapy in this patient group….to ensure we “get the dose right”.