Abstract
19665 Background: Several new biological anti-cancer drugs have been recently licensed, and some of them have shown impressive positive results particularly in tumors that express the targets for these agents (e.g., ERBB2 receptor in breast cancer, KIT mutations in gastrointestinal tumors, and the CD20 expression in NHL). However, the use of these drugs in elderly cancer patients is a matter of debate. The aim of this study was to quantify the use of biological drugs according to age and type of cancer. Methods: We analyzed data regarding patients diagnosed with metastatic breast cancer, NSCLC or colo-rectal cancer and NHL treated with biological drugs (i.e., bevacizumab, cetuximab, rituximab, trastuzumab, erlotinib, geftinib) at the National Cancer Institute of Aviano, North-east Italy, between 2002 and 2006. Patients were stratified according to age (i.e., <=69 years or >=70 years) and type of biological agent used. Results: Overall, 687 patients were treated with biological agents (360 with rituximab, 149 with trastuzumab, 114 with geftinib, 23 with bevacizumab, 21 with erlotinib and 20 with cetuximab). Older patients (n=103) had a median age of 74 years (range: 70–86 years): they represented 17.5% of those treated with rituximab, 7.4% of those treated with trastuzumab, 20.2% of those treated with geftinib. Moreover, one elderly cancer patient in each of the three groups of drugs less frequently used (i.e., bevacizumab, erlotinib and cetuximab) was treated with biological agents. Conclusions: In our Institute, nearly 20% of cancer patients is aged 70 years or older. Our findings suggest that elderly cancer patients are not denied biological therapies because of their age. This is particularly true for NHL patients treated with rituximab (17.5%) and for patients with NSCLC treated with geftinib. The low percentage of elderly women treated with trastuzumab is likely to depend from the biological (e.g. hormonal receptors) and clinical characteristics (e.g., pre-existing cardiovascular conditions and life expectancy) of breast cancer in elderly women. The increasing number of cancer in the elderly, asks for a proper selection of patients who should have access to biological agents according to clinical studies and cost-effectiveness evaluation. No significant financial relationships to disclose.
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