Effect of age on drug metabolism in women with breast cancer Journal Article

Authors: Singh, J. C.; Lichtman, S. M.
Article Title: Effect of age on drug metabolism in women with breast cancer
Abstract: Introduction: The aging of the population will increase the number of breast cancer patients requiring treatment in both the adjuvant and metastatic setting. Hormones, chemotherapy and targeted drugs all have a role in treatment. Older patients have been underrepresented in clinical trials making evidence-based decisions difficult. The increase in comorbidity and aging, polypharmacy and changes in function make pharmacotherapy decisions more complicated. Knowledge of the issues is critical in the prescribing of effective and safe therapy. There are factors associated with advancing age that can result in pharmacokinetic and pharmacodynamic variations in processing of hormonal agents, chemotherapy and targeted drugs.Areas covered: A review of the literature pertaining to pharmacokinetic changes in aging in breast cancer was untaken. Studies are reviewed involving single agents and some combinations.Expert opinion: Older patients should be considered for standard therapies. Their specific problems need to be evaluated by geriatric-specific assessment including functional status, end organ dysfunction and polypharmacy. There are few instances for age-related changes in pharmacokinetics and when present are usually not clinically significant. When changes are present, they are often the result of comorbidity, drug interactions and drug scheduling issues. The older patients may be more sensitive to certain toxicities such as cardiac toxicity, neuropathy and myelosuppression. © 2015 Informa UK, Ltd.
Keywords: review; fluorouracil; cancer combination chemotherapy; capecitabine; cancer patient; methotrexate; antineoplastic agent; pharmacodynamics; breast cancer; bone marrow suppression; neuropathy; aromatase inhibitor; cyclophosphamide; cancer hormone therapy; cardiotoxicity; comorbidity; tamoxifen; aging; drug metabolism; taxane derivative; navelbine; anthracycline; elderly; fluoropyrimidine; functional status; pharmacokinetics; polypharmacy; geriatrics; multiple organ failure; molecularly targeted therapy; renal insufficiency; human; cyp450
Journal Title: Expert Opinion on Drug Metabolism and Toxicology
Volume: 11
Issue: 5
ISSN: 1742-5255
Publisher: Informa Healthcare  
Date Published: 2015-05-01
Start Page: 757
End Page: 766
Language: English
DOI: 10.1517/17425255.2015.1037277
PROVIDER: scopus
PUBMED: 25940027
PMCID: PMC5057182
Notes: Export Date: 3 June 2015 -- Source: Scopus
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MSK Authors
  1. Stuart Lichtman
    165 Lichtman
  2. Jasmeet Chadha Singh
    11 Singh