scholarly journals Drug–drug interaction in elderly patients with cancer

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Romana Capitão ◽  
Ângelo Jesus ◽  
Rita Oliveira ◽  
Vera Afreixo
Keyword(s):  
High Risk ◽  
Elderly Patients ◽  
Drug Interactions ◽  
Cancer Patients ◽  
The Elderly ◽  
Elderly Cancer Patients ◽  
Chronic Medication ◽  
Patients With Cancer

Abstract Background Elderly cancer patients have a high risk of exposure to potential drug-drug interactions (pDDIs), given the therapeutic complexity to which they are subjected. The study of pDDIs is very important to enable more effective treatments, with the least possible number of complications.The aim of this study was to identify and characterize pDDIs in elderly cancer patients treated at the Day Hospital of IPO-Porto. Methods Information about patients sociodemographic data and chronic medication were collected through an interview with application of a questionnaire to the elderly patient. Patient’s clinical files were also consulted to complement information needed for the study. The ATC classification of drugs was performed and Micromedex® tool was used to identify and characterize pDDIs. The most prevalent pDDIs were analyzed and discussed. Results A total of 335 elderly patients with cancer were enrolled in the study. The prevalence of polymedication was 88.10% and excessive polymedication was 46.60%. A total of 1125 pDDIs were identified in 248 patients (74.03%) and 211 pDDIs involved at least one antineoplastic drug. The pDDIs that were detected more frequently were: Fluorouracil - Leucovorin Calcium (N = 28), Cyclophosphamide - Ondansetron (N = 27) and Metoclopramide - Tramadol (N = 20). A significant association was detected between the number of drugs consumed and the number of pDDIs. Conclusions Elderly patients with cancer have a high risk of drug interactions, given the polymedication they are exposed. It's crucial to implement measures to monitor their therapy in order to reduce the potential for drug interactions and improve the quality of patient's life.

A prospective study of the impact of chemotherapy-related toxicities on the quality of life in elderly patients with cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23013-e23013
Author(s):  
Sanketh Kotne ◽  
Bharadwaj Ponnada ◽  
Arun Philip ◽  
Pavithran Keechilat
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Mental Status ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Assessment Tools ◽  
Elderly Cancer Patients

e23013 Background: Treatment of cancer in elderly is challenging. Majority of the elderly cancer patients are offered chemotherapy based on their performance scale and geriatric assessment tools are not routinely employed in clinical practice as they are time consuming and cumbersome. Aim: The primary objective was to estimate the incidence of chemotherapy related adverse events in newly diagnosed elderly cancer patients above 65 years of age treated at a tertiary cancer institute in southern India. The secondary objective was to predict and assess the factors associated with chemotherapy related toxicities in the elderly patients using the Cancer and Aging Research Group's (CARG) scoring tool and to study the quality of life and to assess the nutritional status and the mental status in elderly cancer patients above 65 years of age. Methods: A prospective cross-sectional study was done among 179 patients with age ≥ 65 years, a solid organ cancer (any type or stage) from February 2017 to August 2018. Prechemotherapy comprehensive geriatric assessment (CGA) with Older People’s Quality of Life Questionnaire (OPQOL-35), Mini Nutritional assessment (MNA) and Folstein’s Mini Mental status examination (MMSE) was done at baseline, 2 months and 6 months. CARG tool was used to predict the risk of chemotherapy toxicity with the standard and modified dose. Results: The mean age was 68.53 years. Majority of the patients had breast cancer 29.60%. The proportion of lung cancer, prostate cancer, stomach cancer, colorectal and ovarian cancers were 21.80%,10.60%, 9.50%, 14.5% and 7.30% respectively. Other cancers were seen in 5 patients (2.79%). 40 (22.30%) patients had received anthracycline based chemotherapy. 143 (79.90%) had received standard dosing chemotherapy.118 (65.90%) & 125 (69.80%) out of 179 patients had developed hematological toxicities and non- hematological toxicities respectively. According to the ROC curve for the CARG tool risk of toxicity with standard & modified dosing and hematological & non- hematological toxicities, the accuracy of the test is 60.89% indicating its poor predictive validity. There is a decline in the CGA at 2 months follow-up, but there was an improvement after assessment at 6 months. Conclusions: Comprehensive geriatric assessment at base line is required to adequately analyse patient’s risk of chemotherapy related toxicities. In our study, the patients have tolerated the chemotherapy well in spite of receiving standard dosing.

Prospective Evaluation of the Pharmacokinetics and Toxicity Profile of Docetaxel in the Elderly

2005 ◽  
Vol 23 (6) ◽  
pp. 1070-1077 ◽  
Author(s):  
Albert J. ten Tije ◽  
Jaap Verweij ◽  
Michael A. Carducci ◽  
Wilfried Graveland ◽  
Theresa Rogers ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Patient Characteristics ◽  
The Elderly ◽  
Pharmacokinetic Studies ◽  
Toxicity Profile ◽  
Elderly Cancer Patients ◽  
Patients With Cancer ◽  
Plasma Pharmacokinetics

Purpose To prospectively study the pharmacokinetics and toxicity profile of docetaxel in elderly patients with cancer. Patients and Methods Docetaxel was administered at a dose 75 mg/m2 once every 3 weeks to 25 elderly cancer patients aged ≥ 65 years and 26 cancer patients aged younger than 65 years. Pharmacokinetic studies and toxicity assessments were performed during the first cycle of therapy. Results Of 51 patients treated, 20 aged ≥ 65 years (median, 71 years; range, 65 to 80 years) and 20 aged younger than 65 years (median, 53 years; range, 26 to 64 years) were assessable for pharmacokinetic studies, and 39 were assessable for toxicity. Patient characteristics were similar (P ≥ .15) between the two cohorts. Mean docetaxel clearance was not altered in the elderly versus younger patients: 30.1 L/h (standard deviation [SD] 18.3 L/h) v 30.0 L/h (SD, 14.8 L/h; P = .98). The percentage of patients with grade 4 and febrile neutropenia was higher in the elderly (63% and 16%, respectively) versus younger (30% and 0%, respectively) cohort, although this observation did not reach a level of statistical significance (P = .056). From logistic regression analysis, the odds ratio for a patient aged 65 years was 1.98 for developing grade 4 neutropenia compared with a patient aged 50 years (P = .091). Conclusion Docetaxel plasma pharmacokinetics are unaltered in elderly patients. Patients aged ≥ 65 years appear to be more sensitive to docetaxel-induced neutropenia.

scholarly journals Predictors of Noncompletion of Cancer Treatments in Elderly Patients: the Elderly Cancer Patients (Elcapa) Cohort Study

2012 ◽  
Vol 23 ◽  
pp. ix452
Author(s):  
M. Laurent ◽  
E. Paillaud ◽  
M. Carvalho-Verlinde ◽  
P. Caillet ◽  
A. Le Thuaut ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Cancer Patients ◽  
The Elderly ◽  
Cancer Treatments ◽  
Elderly Cancer Patients

Supportive Care Considerations for Older Adults With Cancer

2014 ◽  
Vol 32 (24) ◽  
pp. 2627-2634 ◽  
Author(s):  
Arash Naeim ◽  
Matti Aapro ◽  
Rashmi Subbarao ◽  
Lodovico Balducci
Keyword(s):  
Elderly Patients ◽  
Supportive Care ◽  
Chronic Conditions ◽  
Treatment Options ◽  
The Elderly ◽  
Strongly Correlated ◽  
Lifestyle Management ◽  
Patients With Cancer ◽  
Age Appropriate

The treatment of cancer presents specific concerns that are unique to the growing demographic of elderly patients. Because the incidence of cancer is strongly correlated with aging, the expansion of supportive care and other age-appropriate therapies will be of great importance as the population of elderly patients with cancer increases in the coming years. Elderly patients are especially likely to experience febrile neutropenia, complications from chemotherapy-induced nausea, anemia, osteoporosis (especially in patients diagnosed with breast or prostate cancer), depression, insomnia, and fatigue. These issues are often complicated by other chronic conditions related to age, such as diabetes and cardiac disease. For many patients, symptoms may be addressed both through lifestyle management and pharmaceutical approaches. Therefore, the key to improving quality of life for the elderly patient with cancer is an awareness of their specific needs and a familiarity with emergent treatment options.

scholarly journals Correlation between comorbidity and quality of life in the elderly cancer patients treated with chemotherapy: An ongoing study

2002 ◽  
Vol 10 (3) ◽  
pp. 146-146
Author(s):  
Svetlana Jezdic ◽  
Zorica Nikolic-Tomasevic ◽  
Ivan Popov ◽  
Davorin Radosavljevic
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
The Elderly ◽  
Ongoing Study ◽  
Elderly Cancer Patients

Risk factors for hospitalization in elderly cancer patients receiving chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9035-9035
Author(s):  
J. M. Kleiner ◽  
E. Culakova ◽  
D. C. Dale ◽  
J. Crawford ◽  
M. S. Poniewierski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Solid Tumors ◽  
Univariate Analysis ◽  
The Elderly ◽  
Hematologic Toxicity ◽  
Elderly Age ◽  
Elderly Cancer Patients ◽  
Increased Risk

9035 Background: Chemotherapy-associated hospitalization is a major source of morbidity and cost in cancer care, particularly for elderly (age ≥ 65) cancer patients. Hospitalization in the elderly often leads to an irreversible decline in functional status unrelated to the acute event that prompted hospital admission. Currently, little is known about the risk factors that may lead to increased risk of hospitalization in elderly patients receiving chemotherapy (CTX). Methods: 871 patients with solid tumors or lymphoma initiating a new CTX regimen were prospectively enrolled at 60 randomly selected US community oncology sites between 8/2004 and 10/2005. Of these, 361 elderly patients aged 65–91 were identified and followed. Primary endpoint of this investigation was hematologic toxicity and hospitalization was secondary. Pre- CTX patient data were analyzed for increased risk of hospitalization in univariate analysis using the chi-square test. Results: A total of 155 (18%) patients were hospitalized resulting in 215 hospitalizations. Median time to first hospitalization was the second cycle of CTX. 81/361 (22%) of elderly patients were hospitalized compared to only 74/510 (15%) of younger patients (p=0.003). The rate of hospitalization increased in a linear fashion between ages 65–80. Reasons for hospitalization in the elderly included infection, fever, or febrile neutropenia (36%), cardiopulmonary disease (CPD) (12%), vomiting or dehydration (13%), other gastrointestinal (11%), transfusion (8%), thrombosis (4%), CTX administration (4%), and other (13%). Major independent pre-CTX factors that predicted hospitalization in the elderly included male gender (p=0.0004), hemoglobin <11 g/dL (p=0.02), abnormal platelet count (<150k or >350k) (p=0.05), CPD (p=0.03), creatinine >1.5 mg/dL (p=0.05), and ≥ 2 concomitant medications (p=0.0008). Elderly patients with lung cancer (p=0.001) and lymphoma (p=0.05) had significantly higher rates of hospitalization when compared to other solid tumors. Conclusions: These data suggest that the risk of hospitalization increases in elderly cancer patients with age and that pre-CTX factors may be useful in identifying a subpopulation at increased risk for hospitalization. No significant financial relationships to disclose.

Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort

2020 ◽  
Vol 11 (4) ◽  
pp. 586-592 ◽  
Author(s):  
Guillaume Beinse ◽  
Delphine Reitter ◽  
Lauriane Segaux ◽  
Muriel Carvahlo-Verlinde ◽  
Benoit Rousseau ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Cancer Patients ◽  
Older Patients ◽  
Potential Drug ◽  
Elderly Cancer Patients ◽  
Patients With Cancer

scholarly journals Self-care of elderly cancer patients undergoing outpatient treatment

2014 ◽  
Vol 23 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Lucimara Sonaglio Rocha ◽  
Margrid Beuter ◽  
Eliane Tatsch Neves ◽  
Marinês Tambara Leite ◽  
Cecília Maria Brondani ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cancer Patients ◽  
Outpatient Treatment ◽  
Self Care ◽  
The Elderly ◽  
University Hospital ◽  
Structured Interviews ◽  
Elderly Cancer Patients ◽  
Care Of Elderly ◽  
Living With Cancer

This is a qualitative descriptive study with the aim to analyze the self-care of elderly cancer patients undergoing outpatient treatment, from the perspective of their autonomy. Fifteen elderly individuals undergoing treatment in a blood-oncology outpatient center of a university hospital participated in the research. Data were collected with semi-structured interviews conducted in 2010. Independence and ability for self-care by the elderly patients were evaluated using the Katz and Lawton scales. The data collected were submitted to thematic analysis. Four categories were identified: manifestations of self-care of elderly cancer patients; care in the family and its dynamics; adaptation to the limitations of the disease; and living with finiteness. In conclusion, the autonomy for self-care of the elderly patients is manifested in the concern with diet, knowing their bodies' limits, the changes imposed by living with cancer and family support.

scholarly journals Comorbidity in Older Patients Hospitalized with Cancer in Northeast China based on Hospital Discharge Data

2020 ◽  
Vol 17 (21) ◽  
pp. 8028
Author(s):  
Xiao-Min Mu ◽  
Wei Wang ◽  
Fang-Yi Wu ◽  
Yu-Ying Jiang ◽  
Ling-ling Ma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Liver Cancer ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Hospital Discharge ◽  
Hospital Discharge Data ◽  
Discharge Data ◽  
Elderly Cancer Patients ◽  
Patients With Cancer ◽  
Digestive Diseases

Patients with cancer often carry the dual burden of the cancer itself and other co-existing medical conditions. The problems associated with comorbidities among elderly cancer patients are more prominent compared with younger patients. This study aimed to identify common cancer-related comorbidities in elderly patients through routinely collected hospital discharge data and to use association rules to analyze the prevalence and patterns of these comorbidities in elderly cancer patients at different cancer sites. We collected the discharge data of 80,574 patients who were diagnosed with cancers of the esophagus, stomach, colorectum, liver, lung, female breast, cervix, and thyroid between 2016 and 2018. The same number of non-cancer patients were randomly selected as the control group and matched with the case group by age and gender. The results showed that cardiovascular diseases, metabolic diseases, digestive diseases, and anemia were the most common comorbidities in elderly patients with cancer. The comorbidity patterns differed based on the cancer site. Elderly patients with liver cancer had the highest risk of comorbidities, followed by lung cancer, gastrointestinal cancer, thyroid cancer, and reproductive cancer. For example, elderly patients with liver cancer had the higher risk of the comorbid infectious and digestive diseases, whereas patients with lung cancer had the higher risk of the comorbid respiratory system diseases. The findings can assist clinicians in diagnosing comorbidities and contribute to the allocation of medical resources.

Inclusion of patient-reported outcomes (PROs) in randomized controlled trials (RCTs) with elderly cancer patients: A systematic review.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18217-e18217
Author(s):  
Francesco Sparano ◽  
Neil K Aaronson ◽  
Mirjam A.G. Sprangers ◽  
Peter Fayers ◽  
Andrea Pusic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Patient Reported Outcomes ◽  
Data Extraction ◽  
The Elderly ◽  
Cochrane Library ◽  
Elderly Cancer Patients ◽  
Patient Reported ◽  
Cancer Sample

e18217 Background: Inclusion of PROs in RCTs involving elderly cancer patients may be particularly important, as the elderly are often frail and vulnerable, and treatment decisions need to carefully balance potential burden against benefit. We aimed to determine how many RCTs involving elderly patients have included a PRO endpoint, and identified the most relevant PRO information available in this area. Methods: A systematic review in PubMed/Medline and Cochrane Library identified RCTs with PRO endpoint that enrolled a cancer sample (breast, colorectal, lung, prostate, gynaecological and bladder cancer) with a mean/ median age ≥70 years, published from January 2004 to June 2018. The quality of PRO reporting was evaluated using the ISOQOL-PRO recommended criteria. Two reviewers independently performed data extraction. RCTs meeting at least two-thirds of the recommended criteria were considered as “probably-robust” and therefore most likely to be able to inform patient care. Results: Out of the 610 RCTs with PRO endpoint identified, only 67 RCTs (11%) enrolled a sample that met the above criteria. In 19 RCTs (28.4%) PROs were the primary endpoint and 35 RCTs (52.2%) were conducted in a metastatic population. Less than one-third of these trials (n = 21) were considered as probably-robust. In 10 (47.6%) out of the 21 probably-robust RCTs, PROs favored the experimental arm and in 8 (38.1%) the arms did not differ. Overall survival (OS) was an endpoint in 13 of the probably-robust RCTs. In only 3 of these RCTs (23.1%) did OS improve in the experimental arm and in 10 (76.9%) there was no difference in OS between arms. In about half of the probably-robust trials evaluating OS (n = 7, 53.8%), PROs provided information that contrasted with survival findings. In two RCTs, OS improved in the experimental arm, while PROs either did not change between arms (n = 1) or favoured the control arm (n = 1). Conversely, in 5 RCTs (38.5%), OS did not differ between arms whereas PROs favoured the experimental arm. Conclusions: Among cancer RCTs including PROs, the proportion of those conducted in the elderly is low. However, PRO data may provide useful information for these type of patients and their clinicians.

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