Are the elderly predisposed to toxicity from cancer chemotherapy? An investigation using data from the Eastern Cooperative Oncology Group.

Cancer management of the elderly is a topic which has received relatively little attention. This is surprising in view of the fact that approximately 50% of all cancers occur in patients over 65 years of age. In this paper, six terminated studies of the Eastern Cooperative Oncology Group involving approximately 3000 cancer patients have been examined to characterize the nature and extent of the susceptibility to toxicity of elderly patients undergoing chemotherapy for cancer. The six studies were restricted to three primary sites: lung, breast, and colorectum. The results indicate that elderly cancer patients in the study did not experience any increase in the frequency or severity of the toxicity of chemotherapy. The data do not indicate any systematic bias in patient selection with respect to important clinical variables such as performance status, prior treatment, and presence of liver metastases. Compliance with dosage regimen as prescribed by the protocol was similar for each age group during the course of studies. Comparability was further indicated by the fact that the response rates among the elderly were equivalent to the rest of the patient population. The results have important implications for cancer management of the elderly.