CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2021; 42(03): 229-239
DOI: 10.1055/s-0041-1732784
Review Article

Management of Metastatic Nonsmall Cell Lung Cancer in Elderly

Hardik Sheth
1  Division of Medical Oncology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
,
Prashant Kumar
2  Division of Molecular Biology Institute of Bioinformatics, International Technology Park, Bangalore, Karnataka, India
3  Division of Medical Oncology, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
,
Sewanti Limaye
1  Division of Medical Oncology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
› Author Affiliations

Abstract

There is limited data on management of metastatic nonsmall cell lung cancer (NSCLC) in the elderly population due to lack of representation of this subset in clinical trials. The projected representation of elderly population of patients globally is expected to rise significantly in the years to come. It is imperative to understand the specific challenges and opportunities in management of elderly with NSCLC. Even in the elderly, the medical management of advanced NSCLC begins with driver mutation testing on lung biopsy. Once the patient is classified as driver mutation positive or negative, they can either be treated with a single-agent-targeted therapy or with immunotherapy and chemotherapy or after programmed death ligand 1 (PDL-1) assessment, with immunotherapy alone. After starting the appropriate therapy, the disease needs to be monitored at every 3 months with reassessment scans. Treatment in elderly should be designed as per their functional and not chronological age, and geriatric assessment scales should be utilized wherever possible to understand the functional age of the patient.



Publication History

Publication Date:
20 September 2021 (online)

© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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