Abstract
We performed a bibliographic electronic search of MEDLINE and Cochrane databases on breast cancer in the elderly. In the adjuvant setting aromatase inhibitors are more effective than tamoxifen with an acceptable profile of toxicity. In aged, poorer risk, patients adjuvant chemotherapy is feasible but organ function and comorbidities have to be considered. Adjuvant trastuzumab is also an option for the treatment of Her2 positive aged breast cancer. Neoadjuvant chemotherapy ± HER2-targeted treatment is today a possible treatment for triple negative and HER2-positive disease, respectively. Older women are more likely than younger women to present with more advanced breast cancer. Hormone therapy is the treatment of choice for older women with hormone receptor positive metastatic breast cancer until they develop resistance. When appropriate, polychemotherapy may be employed but unfortunately we have a lack of data on this matter. However, because fit women older than 70 years of age have similar results with chemotherapy as their younger counterparts most oncologists tend to propose this option to their patients. Trastuzumab has proven to be effective and well tolerated in elderly patients (older than 60-70 years), but caution is needed due to the risk of heart failure. Recently, an all-oral combination of capecitabine and vinorelbine demonstrated good acitivity and tolerability profile in patients older than 70 years. Nab-paclitaxel has shown a safer and more active profile compared with the q3w taxanes in such population. There is, therefore, an urgent need to study anticancer agents in the elderly within large randomized controlled trials.
Keywords: Elderly, breast cancer, chemotherapy, hormone therapy, adjuvant, neoadjuvant, metastatic.
Anti-Cancer Agents in Medicinal Chemistry
Title:Medical Treatment Of Elderly Patients With Breast Cancer
Volume: 13 Issue: 9
Author(s): Sergio Palmeri, Massimiliano Berretta and Laura Palmeri
Affiliation:
Keywords: Elderly, breast cancer, chemotherapy, hormone therapy, adjuvant, neoadjuvant, metastatic.
Abstract: We performed a bibliographic electronic search of MEDLINE and Cochrane databases on breast cancer in the elderly. In the adjuvant setting aromatase inhibitors are more effective than tamoxifen with an acceptable profile of toxicity. In aged, poorer risk, patients adjuvant chemotherapy is feasible but organ function and comorbidities have to be considered. Adjuvant trastuzumab is also an option for the treatment of Her2 positive aged breast cancer. Neoadjuvant chemotherapy ± HER2-targeted treatment is today a possible treatment for triple negative and HER2-positive disease, respectively. Older women are more likely than younger women to present with more advanced breast cancer. Hormone therapy is the treatment of choice for older women with hormone receptor positive metastatic breast cancer until they develop resistance. When appropriate, polychemotherapy may be employed but unfortunately we have a lack of data on this matter. However, because fit women older than 70 years of age have similar results with chemotherapy as their younger counterparts most oncologists tend to propose this option to their patients. Trastuzumab has proven to be effective and well tolerated in elderly patients (older than 60-70 years), but caution is needed due to the risk of heart failure. Recently, an all-oral combination of capecitabine and vinorelbine demonstrated good acitivity and tolerability profile in patients older than 70 years. Nab-paclitaxel has shown a safer and more active profile compared with the q3w taxanes in such population. There is, therefore, an urgent need to study anticancer agents in the elderly within large randomized controlled trials.
Export Options
About this article
Cite this article as:
Palmeri Sergio, Berretta Massimiliano and Palmeri Laura, Medical Treatment Of Elderly Patients With Breast Cancer, Anti-Cancer Agents in Medicinal Chemistry 2013; 13 (9) . https://dx.doi.org/10.2174/18715206113136660358
DOI https://dx.doi.org/10.2174/18715206113136660358 |
Print ISSN 1871-5206 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5992 |
Call for Papers in Thematic Issues
Induction of cell death in cancer cells by modulating telomerase activity using small molecule drugs
Telomeres are distinctive but short stretches present at the corners of chromosomes and aid in stabilizing chromosomal makeup. Resynthesis of telomeres supported by the activity of reverse transcriptase ribonucleoprotein complex telomerase. There is no any telomerase activity in human somatic cells, but the stem cells and germ cells undergone telomerase ...read more
Role of natural compounds as anti anti-cancer agents
Cancer is considered the leading cause of worldwide mortality, accounting for nearly 10 million deaths in 2022. Cancer outcome can be improved through an appropriate screening and early detection and through an efficient clinical treatment. Chemotherapy remains an important approach in treatment o f several types of cancers, even though ...read more
Signaling and enzymatic modulators in cancer treatment
Cancer accounts for nearly 10 million deaths in 2022 and is considered the leading cause of worldwide mortality. Cancer outcome can be improved through an appropriate screening and early detection and through an efficient clinical treatment. Chemotherapy, radiotherapy and surgery are the most important approach for the treatment of several ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Cardio-protective Effects of Glucagon-like Peptide-1 Receptor Agonists: An Overview of Systematic Reviews and Publication Overlap
Current Pharmaceutical Design Osteoprotegerin in Cardiovascular Disease: Ally or Enemy?
Current Pharmaceutical Design Oxidative Stress in Tumor Angiogenesis - Therapeutic Targets
Current Pharmaceutical Design Acute Coronary Syndromes as Auto-Inflammatory Disorders
Current Pharmaceutical Design Glycogen Phosphoprylase (EC 2.4.1.1) Activity During Cardiopulmonary Bypass in Patients Undergoing Cardiac Surgery
Vascular Disease Prevention (Discontinued) Contextualizing the Genes Altered in Bladder Neoplasms in Pediatric and Teen Patients Allows Identifying Two Main Classes of Biological Processes Involved and New Potential Therapeutic Targets
Current Genomics Curcumin: Not So Spicy After All
Mini-Reviews in Medicinal Chemistry Cellular and Molecular Mechanisms of Curcumin in Thyroid Gland Disorders
Current Medicinal Chemistry Building A New Treatment For Heart Failure-Transplantation of Induced Pluripotent Stem Cell-derived Cells into the Heart
Current Gene Therapy Metalloproteinases and Metalloproteinase Inhibitors in Age-Related Diseases
Current Pharmaceutical Design Intraperitoneal Drug Therapy: An Advantage
Current Clinical Pharmacology Fused 1,4-Dihydropyridines as Potential Calcium Modulatory Compounds
Mini-Reviews in Medicinal Chemistry Tocotrienols and Cardiovascular Health
Current Pharmaceutical Design Drug Eluting Stents in Interventional Cardiology - Current Evidence and Emerging Uses
Current Drug Targets - Cardiovascular & Hematological Disorders Pentacyclic Triterpenoids and Their Saponins with Apoptosis-Inducing Activity
Current Topics in Medicinal Chemistry Cardiovascular Complications of HIV Infection and Treatment
Cardiovascular & Hematological Agents in Medicinal Chemistry Novel Molecular Targets in the Treatment of Cardiac Hypertrophy
Recent Patents on Cardiovascular Drug Discovery Natriuretic Peptide Family: New Aspects
Current Medicinal Chemistry - Cardiovascular & Hematological Agents MK-0626, A Dipeptidyl Peptidase-4 Inhibitor, Improves Neovascularization by Increasing Both the Number of Circulating Endothelial Progenitor Cells and Endothelial Nitric Oxide Synthetase Expression
Current Medicinal Chemistry Small Ruminant Lentiviruses and Human Immunodeficiency Virus: Cousins that Take a Long View
Current HIV Research