Features of anticancer drug therapy in the elderly

The growing proportion of elderly patients among individuals with cancer necessitates adapting systemic anticancer therapy to account for age-related physiological changes, comorbidities, and toxicity risks. Despite concerns about tolerability of aggressive regimens in older populations, evidence suggests that, with appropriate patient selection, toxicity rates may be comparable to those in younger individuals. Comprehensive 
geriatric assessment—including frailty evaluation, functional status assessment, and comorbidity stratification—is critical for optimizing treatment strategies. Age-related pharmacokinetic and pharmacodynamic changes in the liver, kidneys, and cardiovascular system, as well as polypharmacy, require careful monitoring and individualized dosing. Prognostic models such as the Cancer and Aging Research Group (CARG) score improve prediction of severe adverse events and help guide therapeutic decision-making