Making appropriate treatment decisions for older adults with cancer is one of the most important challenges that oncologists face in daily practice, as the therapy selected depends on an assessment of the patient’s “fitness.”
The CALGB 369901 trial examined how frailty and older age influence the use of adjuvant hormonal therapy for breast cancer and found that while frailty can deter the start of therapy, frail patients who had started on a regimen were not much more likely to discontinue their treatment early.
Results from a retrospective analysis indicate that the use of the antiangiogenic, VEGF inhibitor sorafenib for the treatment of advanced renal cell carcinoma was well tolerated in patients aged 65 years or older.
Elderly patients may have several such comorbidities, but their impact on normal life is minimal—and so most of these patients may receive a curative treatment such as R-CHOP. Very elderly patients have more comorbidities with greater impact, with the result that some of their vital organs exhibit functional deficiency.