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Tyrosine Kinase Inhibitors for the Elderly.

Hohenforst-Schmidt W, Zarogoulidis P, Steinheimer M, Benhassen N, Tsiouda T, Baka S, Yarmus L, Stratakos G, Organtzis J, Pataka A, Tsakiridis K, Karapantzos I, Karapantzou C, Darwiche K, Zissimopoulos A, Pitsiou G, Zarogoulidis K, Man YG, Rittger H - J Cancer (2016)

Bottom Line: The side effects of these agents are still severe for several patients.TKIs in most studies presented safety and efficiency and of course dose modification should be made when necessary.Comorbidities should be considered in any case especially in this group of patients and the treating physician should act accordingly.

View Article: PubMed Central - PubMed

Affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.

ABSTRACT
Until few years ago non-specific cytotoxic agents were considered the tip of the arrow as first line treatment for lung cancer. However; age > 75 was considered a major drawback for this kind of therapy. Few exceptions were made by doctors based on the performance status of the patient. The side effects of these agents are still severe for several patients. In the recent years further investigation of the cancer genome has led to targeted therapies. There have been numerous publications regarding novel agents such as; erlotinib, gefitinib and afatinib. In specific populations these agents have demonstrated higher efficiency and this observation is explained by the overexpression of the EGFR pathway in these populations. We suggest that TKIs should administered in the elderly, and with the word elderly we propose the age of 75. The treating medical doctor has to evaluate the performance status of a patient and decide the best treatment in several cases indifferent of the age. TKIs in most studies presented safety and efficiency and of course dose modification should be made when necessary. Comorbidities should be considered in any case especially in this group of patients and the treating physician should act accordingly.

No MeSH data available.


Related in: MedlinePlus

EGFR; Epidermal Growth Factor, AKT; kinase-interacting protein1, PTEN; Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase, PI3K; Phosphatidylinositol-3-kinases, PI 3-kinases, PI(3)Ks, RAS; Ras superfamily of proteins, which are all related in 3D structure and regulate diverse cell behaviours, RAF; Raf kinases (more avidly C-Raf than B-Raf), MAPK/ERK; extracellular signal-regulated kinases , TKI; Tyrosine kinase inhibitor, STAT; Signal Transducers and Activators of Transcription. MEK; mitogen-activated protein kinase kinase enzymes MEK1 and/or MEK2.
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Related In: Results  -  Collection


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Figure 1: EGFR; Epidermal Growth Factor, AKT; kinase-interacting protein1, PTEN; Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase, PI3K; Phosphatidylinositol-3-kinases, PI 3-kinases, PI(3)Ks, RAS; Ras superfamily of proteins, which are all related in 3D structure and regulate diverse cell behaviours, RAF; Raf kinases (more avidly C-Raf than B-Raf), MAPK/ERK; extracellular signal-regulated kinases , TKI; Tyrosine kinase inhibitor, STAT; Signal Transducers and Activators of Transcription. MEK; mitogen-activated protein kinase kinase enzymes MEK1 and/or MEK2.

Mentions: In the current mini review we will focus on the group of patients >70 years of age. We will present up to date studies and comment on the targeted treatment for this group of patients. (Figure 1)


Tyrosine Kinase Inhibitors for the Elderly.

Hohenforst-Schmidt W, Zarogoulidis P, Steinheimer M, Benhassen N, Tsiouda T, Baka S, Yarmus L, Stratakos G, Organtzis J, Pataka A, Tsakiridis K, Karapantzos I, Karapantzou C, Darwiche K, Zissimopoulos A, Pitsiou G, Zarogoulidis K, Man YG, Rittger H - J Cancer (2016)

EGFR; Epidermal Growth Factor, AKT; kinase-interacting protein1, PTEN; Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase, PI3K; Phosphatidylinositol-3-kinases, PI 3-kinases, PI(3)Ks, RAS; Ras superfamily of proteins, which are all related in 3D structure and regulate diverse cell behaviours, RAF; Raf kinases (more avidly C-Raf than B-Raf), MAPK/ERK; extracellular signal-regulated kinases , TKI; Tyrosine kinase inhibitor, STAT; Signal Transducers and Activators of Transcription. MEK; mitogen-activated protein kinase kinase enzymes MEK1 and/or MEK2.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4829555&req=5

Figure 1: EGFR; Epidermal Growth Factor, AKT; kinase-interacting protein1, PTEN; Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase, PI3K; Phosphatidylinositol-3-kinases, PI 3-kinases, PI(3)Ks, RAS; Ras superfamily of proteins, which are all related in 3D structure and regulate diverse cell behaviours, RAF; Raf kinases (more avidly C-Raf than B-Raf), MAPK/ERK; extracellular signal-regulated kinases , TKI; Tyrosine kinase inhibitor, STAT; Signal Transducers and Activators of Transcription. MEK; mitogen-activated protein kinase kinase enzymes MEK1 and/or MEK2.
Mentions: In the current mini review we will focus on the group of patients >70 years of age. We will present up to date studies and comment on the targeted treatment for this group of patients. (Figure 1)

Bottom Line: The side effects of these agents are still severe for several patients.TKIs in most studies presented safety and efficiency and of course dose modification should be made when necessary.Comorbidities should be considered in any case especially in this group of patients and the treating physician should act accordingly.

View Article: PubMed Central - PubMed

Affiliation: 1. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Fuerth, Germany.

ABSTRACT
Until few years ago non-specific cytotoxic agents were considered the tip of the arrow as first line treatment for lung cancer. However; age > 75 was considered a major drawback for this kind of therapy. Few exceptions were made by doctors based on the performance status of the patient. The side effects of these agents are still severe for several patients. In the recent years further investigation of the cancer genome has led to targeted therapies. There have been numerous publications regarding novel agents such as; erlotinib, gefitinib and afatinib. In specific populations these agents have demonstrated higher efficiency and this observation is explained by the overexpression of the EGFR pathway in these populations. We suggest that TKIs should administered in the elderly, and with the word elderly we propose the age of 75. The treating medical doctor has to evaluate the performance status of a patient and decide the best treatment in several cases indifferent of the age. TKIs in most studies presented safety and efficiency and of course dose modification should be made when necessary. Comorbidities should be considered in any case especially in this group of patients and the treating physician should act accordingly.

No MeSH data available.


Related in: MedlinePlus