Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions

Orazio Caffo, Francesca Maines, Mimma Rizzo, Stefania Kinspergher, Antonello Veccia Medical Oncology Department, Santa Chiara Hospital, Trento, Italy Abstract: The treatment of elderly patients with cancer is usually viewed by clinicians as a challenge, because of the age-related decline in normal...

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Autores principales:	Caffo O, Maines F, Rizzo M, Kinspergher S, Veccia A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	prostate cancer – elderly – castration resistant Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/ecbdea5ed8dc4896afa59048c2446cd3
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spelling	oai:doaj.org-article:ecbdea5ed8dc4896afa59048c2446cd32021-12-02T07:10:14ZMetastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions1178-1998https://doaj.org/article/ecbdea5ed8dc4896afa59048c2446cd32016-12-01T00:00:00Zhttps://www.dovepress.com/metastatic-castration-resistant-prostate-cancer-in-very-elderly-patien-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Orazio Caffo, Francesca Maines, Mimma Rizzo, Stefania Kinspergher, Antonello Veccia Medical Oncology Department, Santa Chiara Hospital, Trento, Italy Abstract: The treatment of elderly patients with cancer is usually viewed by clinicians as a challenge, because of the age-related decline in normal organ function and the frequent concomitant administration of multiple drugs for comorbid conditions. Clinicians therefore tend not to prescribe antineoplastic agents (mainly in the case of chemotherapy) to elderly patients, with the fear of excess toxicity leading to an unfavorable cost:benefit ratio. The cutoff age defining a cancer patient as elderly is usually 70 years, but over the last 10 years clinicians have paid more attention to functional status, as evaluated by means of a comprehensive geriatric assessment and comorbidity burden, rather than chronological age. In the case of metastatic castration-resistant prostate cancer (mCRPC), depending on their age at the time of diagnosis of PC, many (if not most) of the patients are more than 70 years old, and a fair number are very elderly patients aged ≥80 years. The availability of various agents capable of significantly prolonging survival has dramatically changed the therapeutic landscape of mCRPC patients, but very elderly patients are usually underrepresented in pivotal trials. This narrative review considers the available data concerning elderly and very elderly mCRPC patients enrolled in pivotal trials and the information provided by reports of everyday clinical practice, in order to explore the challenges related to the clinical management of this special population. Keywords: prostate cancer, elderly, castration-resistantCaffo OMaines FRizzo MKinspergher SVeccia ADove Medical Pressarticleprostate cancer – elderly – castration resistantGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 19-28 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	prostate cancer – elderly – castration resistant Geriatrics RC952-954.6
spellingShingle	prostate cancer – elderly – castration resistant Geriatrics RC952-954.6 Caffo O Maines F Rizzo M Kinspergher S Veccia A Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
description	Orazio Caffo, Francesca Maines, Mimma Rizzo, Stefania Kinspergher, Antonello Veccia Medical Oncology Department, Santa Chiara Hospital, Trento, Italy Abstract: The treatment of elderly patients with cancer is usually viewed by clinicians as a challenge, because of the age-related decline in normal organ function and the frequent concomitant administration of multiple drugs for comorbid conditions. Clinicians therefore tend not to prescribe antineoplastic agents (mainly in the case of chemotherapy) to elderly patients, with the fear of excess toxicity leading to an unfavorable cost:benefit ratio. The cutoff age defining a cancer patient as elderly is usually 70 years, but over the last 10 years clinicians have paid more attention to functional status, as evaluated by means of a comprehensive geriatric assessment and comorbidity burden, rather than chronological age. In the case of metastatic castration-resistant prostate cancer (mCRPC), depending on their age at the time of diagnosis of PC, many (if not most) of the patients are more than 70 years old, and a fair number are very elderly patients aged ≥80 years. The availability of various agents capable of significantly prolonging survival has dramatically changed the therapeutic landscape of mCRPC patients, but very elderly patients are usually underrepresented in pivotal trials. This narrative review considers the available data concerning elderly and very elderly mCRPC patients enrolled in pivotal trials and the information provided by reports of everyday clinical practice, in order to explore the challenges related to the clinical management of this special population. Keywords: prostate cancer, elderly, castration-resistant
format	article
author	Caffo O Maines F Rizzo M Kinspergher S Veccia A
author_facet	Caffo O Maines F Rizzo M Kinspergher S Veccia A
author_sort	Caffo O
title	Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
title_short	Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
title_full	Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
title_fullStr	Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
title_full_unstemmed	Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
title_sort	metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/ecbdea5ed8dc4896afa59048c2446cd3
work_keys_str_mv	AT caffoo metastaticcastrationresistantprostatecancerinveryelderlypatientschallengesandsolutions AT mainesf metastaticcastrationresistantprostatecancerinveryelderlypatientschallengesandsolutions AT rizzom metastaticcastrationresistantprostatecancerinveryelderlypatientschallengesandsolutions AT kinsperghers metastaticcastrationresistantprostatecancerinveryelderlypatientschallengesandsolutions AT vecciaa metastaticcastrationresistantprostatecancerinveryelderlypatientschallengesandsolutions
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Metastatic castration-resistant prostate cancer in very elderly patients: challenges and solutions

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