Advances in geriatric oncology: a multidisciplinary perspective.

A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians.

Drug-drug interactions in older patients with cancer: a report from the 15th Conference of the International Society of Geriatric Oncology, Prague, Czech Republic, November 2015.

Drugs taken for cancer can interact with each other, with agents taken as part of supportive care, with drugs taken for comorbid conditions (which are particularly common in the elderly patients), and with herbal supplements and complementary medicines. We tend to focus on the narrow therapeutic window of cytotoxics, but the metabolism of tyrosine kinase inhibitors by the cytochrome P450 3A4 enzyme (CYP3A4) makes some TKIs particularly prone to interference with or from other agents sharing this pathway. There is also potential for adverse pharmacokinetic interactions with new hormonal agents used in advanced prostate cancer.

Advances in understanding and treating cardiac cachexia: highlights from the 5th Cachexia Conference.

Cardiac cachexia as a terminal stage of chronic heart failure carries a devastating prognosis. This article focuses on novel insights into the pathophysiology and on new treatment approaches to cardiac cachexia. Drugs that have been used in preclinical and clinical studies that may also confer beneficial effects in cardiac cachexia include but are not limited to the type 4 melanocortin receptor antagonist SNT 207979, the appetite promoting synthetic ghrelin SUN11031, the soluble myostatin decoy receptor ActRIIB-Fc, the fast skeletal muscle troponin activating substance CK-2017357, the anti-catabolic/anabolic transforming agent MT-102, the anti-inflammatory agent celecoxib, and testosterone supplementation.