Mastering chemotherapy dose reduction in elderly cancer patients

Cancer is mainly a disease of the elderly but clinical studies have generally excluded the elderly population for various reasons. Chemotherapy is one of the strongest weapons against (metastatic) cancer, but its use in the elderly has been limited due to fear of inducing toxicity. This review points out 10 recommendations that need to be taken into account when prescribing chemotherapy to elderly patients: aim of chemotherapy, specific pharmacological data for specific chemotherapeutics, treatment individualisation, alternatives to cytotoxic chemotherapy, comprehensive geriatric assessment, supportive therapy, hydration status, drug interactions, and compliance. Each of these topics will be reviewed here trying to give concrete recommendations for clinical practice.