Translational Research And Cancer Management In The Older Person

Translational research has improved enormously the management of cancer in older individuals already, as shown in the following examples:

1. Development of antidotes to the toxicity of cytotoxic chemotherapy. Filgrastim and pegfilgrastim have reduced by more than 50% the incidence of neutropenic infections in older individuals receiving cytotoxic chemotherapy and have allowed a large portion of these patients to receive treatment at full doses (22). At the same time, erythropoietic growth factors have contributed to the preservation of quality of life and functional independence of older cancer patients (22).

2. Development of so-called "targeted" therapy. By targeting a specific neoplastic process, new drugs promise to improve the outcome of treatment and reduce the risk of damage to normal tissues in all patients. As they are at increased risk of therapeutic complications, older individuals may benefit most by targeted therapy.

3. Development of prognostic indices based on genomic and proteomic tumor profile (29). These indices promise to identify individuals more likely to benefit from cytotoxic chemotherapy and limit the use and complications of these forms of treatment.

In addition to these noticeable achievements, translational research promises to benefit the management of cancer of older individuals in several areas, shown in Table 3. The importance of some of these areas, such as the recognition of early markers of carcinogenesis, development of targeted chemoprevention, and new forms of cancer treatment, is self-evident and does not need further explanation. Also, progress in these areas would be beneficial to individuals of all ages. We try to highlight here the areas that are of particular interest to the aged.

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