Toxicity of targeted therapies in elderly patients

Abstract

Targeted therapies have revolutionized the treatment of cancer in recent years. However, treating elderly patients with these new biological therapies remains a challenge. Bevacizumab, a monoclonal antibody directed toward VEGF, appears to increase cardiovascular events in patients who are aged 65 years and over and increases the toxicity in these patients with lung cancer when added to chemotherapy. Owing to the less significant data available concerning the toxicity of trastuzumab and cetuximab, one cannot consider their use to be too toxic for the elderly patient. Rituximab has revolutionized the treatment of lymphomas with no apparent toxic effects in the elderly population. Small-molecule tyrosine kinase inhibitors and immunomodulators – thalidomide and lenalidomide – are emergent drugs that also appear to be efficient and safe for use in these patients. Few data are available concerning the toxicity of biological drugs in the elderly population, hence their use must be evaluated in each single case, always taking into consideration the risk–benefit ratio for the individual patient.