Dose optimization of anticancer drugs in the elderly

Chiyo Imamura

Research output: Contribution to journalArticle

Abstract

Age-related physiological changes affect pharmacokinetics and pharmacodynamics in elderly individuals. Cancer treatment in the elderly requires a careful and multidisciplinary assessment of each patient prior to therapy initiation with respect to treatment decisions and dose optimization considerations, given the wide interpatient variability in this population. As renal function declines with age, renal function assessments are necessary when drugs increasing exposure in renal impairment will be administered to elderly patients. Serum creatinine is an insufficient marker for evaluating renal function in elderly patients because muscle mass decreases with age. Renal function should be assessed according to the index used for dosing recommendation at drug administration planning; in most of drugs, does adjustment is recommended according to the creatinine clearance (Ccr) calculated using the Cockcroft-Gault equation. Elderly patients are apparently more sensitive to cytotoxic agent-induced neutropenia and therefore should be monitored closely. Following the first cycle, a proper assessment of tolerability should be conducted before the second cycle; such assessments are required to discuss the appropriateness of the initiation dose and determine doses during the following cycles for each patient.

Original languageEnglish
Pages (from-to)21-25
Number of pages5
JournalGan to kagaku ryoho. Cancer & chemotherapy
Volume42
Issue number1
Publication statusPublished - 2015 Jan 1

Fingerprint

Kidney
Pharmaceutical Preparations
Creatinine
Cytotoxins
Neutropenia
Therapeutics
Pharmacokinetics
Muscles
Serum
Population
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dose optimization of anticancer drugs in the elderly. / Imamura, Chiyo.

In: Gan to kagaku ryoho. Cancer & chemotherapy, Vol. 42, No. 1, 01.01.2015, p. 21-25.

Research output: Contribution to journalArticle

@article{82b18d4bf287437eaeb623b19778f8f5,
title = "Dose optimization of anticancer drugs in the elderly",
abstract = "Age-related physiological changes affect pharmacokinetics and pharmacodynamics in elderly individuals. Cancer treatment in the elderly requires a careful and multidisciplinary assessment of each patient prior to therapy initiation with respect to treatment decisions and dose optimization considerations, given the wide interpatient variability in this population. As renal function declines with age, renal function assessments are necessary when drugs increasing exposure in renal impairment will be administered to elderly patients. Serum creatinine is an insufficient marker for evaluating renal function in elderly patients because muscle mass decreases with age. Renal function should be assessed according to the index used for dosing recommendation at drug administration planning; in most of drugs, does adjustment is recommended according to the creatinine clearance (Ccr) calculated using the Cockcroft-Gault equation. Elderly patients are apparently more sensitive to cytotoxic agent-induced neutropenia and therefore should be monitored closely. Following the first cycle, a proper assessment of tolerability should be conducted before the second cycle; such assessments are required to discuss the appropriateness of the initiation dose and determine doses during the following cycles for each patient.",
author = "Chiyo Imamura",
year = "2015",
month = "1",
day = "1",
language = "English",
volume = "42",
pages = "21--25",
journal = "Japanese Journal of Cancer and Chemotherapy",
issn = "0385-0684",
publisher = "Japanese Journal of Cancer and Chemotherapy Publishers Inc.",
number = "1",

}

TY - JOUR

T1 - Dose optimization of anticancer drugs in the elderly

AU - Imamura, Chiyo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Age-related physiological changes affect pharmacokinetics and pharmacodynamics in elderly individuals. Cancer treatment in the elderly requires a careful and multidisciplinary assessment of each patient prior to therapy initiation with respect to treatment decisions and dose optimization considerations, given the wide interpatient variability in this population. As renal function declines with age, renal function assessments are necessary when drugs increasing exposure in renal impairment will be administered to elderly patients. Serum creatinine is an insufficient marker for evaluating renal function in elderly patients because muscle mass decreases with age. Renal function should be assessed according to the index used for dosing recommendation at drug administration planning; in most of drugs, does adjustment is recommended according to the creatinine clearance (Ccr) calculated using the Cockcroft-Gault equation. Elderly patients are apparently more sensitive to cytotoxic agent-induced neutropenia and therefore should be monitored closely. Following the first cycle, a proper assessment of tolerability should be conducted before the second cycle; such assessments are required to discuss the appropriateness of the initiation dose and determine doses during the following cycles for each patient.

AB - Age-related physiological changes affect pharmacokinetics and pharmacodynamics in elderly individuals. Cancer treatment in the elderly requires a careful and multidisciplinary assessment of each patient prior to therapy initiation with respect to treatment decisions and dose optimization considerations, given the wide interpatient variability in this population. As renal function declines with age, renal function assessments are necessary when drugs increasing exposure in renal impairment will be administered to elderly patients. Serum creatinine is an insufficient marker for evaluating renal function in elderly patients because muscle mass decreases with age. Renal function should be assessed according to the index used for dosing recommendation at drug administration planning; in most of drugs, does adjustment is recommended according to the creatinine clearance (Ccr) calculated using the Cockcroft-Gault equation. Elderly patients are apparently more sensitive to cytotoxic agent-induced neutropenia and therefore should be monitored closely. Following the first cycle, a proper assessment of tolerability should be conducted before the second cycle; such assessments are required to discuss the appropriateness of the initiation dose and determine doses during the following cycles for each patient.

UR - http://www.scopus.com/inward/record.url?scp=84928699815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928699815&partnerID=8YFLogxK

M3 - Article

VL - 42

SP - 21

EP - 25

JO - Japanese Journal of Cancer and Chemotherapy

JF - Japanese Journal of Cancer and Chemotherapy

SN - 0385-0684

IS - 1

ER -