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05Sep 2019

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Thesis defense Marie-Rose Crombag anti-cancer drugs in the elderly

Promotie Marie-Rose Crombag

A priori dose reductions solely based on age are not advisable and may threaten optimal treatment outcome. This is what Marie-Rose Crombag concludes from her PhD research that she did in the NKI. On 5 September, she defended her thesis at Utrecht University. Her promotor was Jos Beijnen and het co-promotor was Alwin Huitema. 

PK and PD not altered

This thesis presents several studies to evaluate the impact of older age on clinical use and PK and PD of various anticancer treatment options. For the majority of drugs, PK and PD do not appear to be altered in the aging patient population. A priori dose reductions solely based on age are, therefore, not advisable and may threaten optimal treatment outcome. 


For some highly toxic treatments, such as docetaxel, intensified monitoring and use of prophylactic granulocyte colony-stimulating factors in elderly patients may improve treatment tolerability and ultimately survival. Although there is still a paucity of data to draw firm conclusions on the impact of older age on several anticancer drugs, enrollment of elderly patients in oncological pivotal trials seems to have improved. 

Checkpoint inhibitors

For checkpoint inhibitors, the age distribution of the pivotal trial cohorts appears to be representative for those treated with these drugs as part of clinical care. This is promising and will hopefully accelerate knowledge on the impact of older age on PK and PD of new anticancer drugs.

Read more on the Utrecht University website

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