Targeted therapy for elderly patients with non-small cell lung cancer

This analysis aimed to assess whether targeted therapy drugs gefatinib and erlotinib are safer and more effective to treat non-small-cell lung cancer (NSCLC) in elderly patients, compared to chemotherapy and radiation therapies. The authors concluded that these two targeted therapy drugs are effective and safe to treat lung cancer in elderly patients.

Chemotherapy and radiation therapy for cancer can be very toxic to a patient. Given the toxic side effects, these therapies might not be suitable for elderly patients. Targeted therapies, such as tyrosine kinase inhibitors, have been shown to be equally as effective. This type of therapy is used to treat cancers with specific genetic mutations (changes). Whether these therapies are safe in elderly patients is not clear.

The authors performed a meta-analysis on previous studies which assessed the effectiveness and safety of targeted therapy drugs in elderly patients with lung NSCLC.

They selected 6 studies that used erlotinib to treat lung cancer. In 3 of these studies, patients were split into two groups, with group 1 patients aged over 75 years old and group 2 patients aged under 75. The other 3 studies included patients over the age of 70. The most common side effects for patients of any age were rash and diarrhea. The effectiveness of the drug was equal for patients regardless of their age, however toxicity was slightly higher in elderly patients. Eldery patients often have a higher rate of comorbidities (other diseases) which may contribute to a higher rate of side effects.

There were 5 studies that used gefatinib to treat lung cancer. 4 of these studies had patients over the age of 70. The fifth study included two groups of patients: group 1 patients were aged over 70 years old and group 2 aged under 70. Each study showed that gefatinib was effective and safer than chemotherapy drugs for treating lung cancer in elderly patients. No difference in the toxicity of gefatinib was found between younger and older patients.

This meta-analysis concluded that gefatinib and erlotinib are effective and safe to treat NSCLC in elderly patients, compared to cytotoxic agents such as chemotherapy.

The meta-analysis did not include studies using other targeted therapies such as afatinib or crizotinib.

Discuss these treatment options with your physician.