The role of the taxanes in the treatment of older patients with advanced stage non-small cell lung cancer.
The treatment of older patients with advanced non-small cell lung cancer (NSCLC) represents a considerable challenge for physicians. A patient 's suitability for chemotherapy is frequently based solely on chronologic age; as a consequence, older patients with NSCLC are less likely to receive standard chemotherapy than younger patients. Although age-related factors, such as comorbid illness, should be taken into consideration when assessing a patient's suitability for treatment, fit and functionally independent older patients should be considered candidates for standard chemotherapy. The taxanes are widely used in the treatment of advanced-stage NSCLC and are well tolerated in older patients. The efficacy of both paclitaxel and docetaxel has been studied in older patients and appears to be comparable with that seen in younger patients either as monotherapy or in combination with a platinum compound as first-line therapy. In addition to the available evidence, prospective evaluation of novel agents in elderly-specific or -enriched studies is necessary to guide the treatment of older patients with NSCLC.