Lung Cancer in Elderly: Patient-Centered Approach for Optimal Delivery of Care

Background: Lung cancer represents the second most prevalent cause of cancer, and the most common cause of cancer-related mortality among men and women in the United States. Over half the patients diagnosed with lung cancer are over the age of 70 years, and addressing cancer treatment in older adults presents distinct challenges. Over the past two decades, substantial progress has been made in the field of lung cancer treatment, particularly with the advent of immunotherapy and targeted therapies in the management of NSCLC. These treatment modalities have demonstrated effectiveness and a favorable tolerance profile, even among elderly individuals. Objectives: The primary aim of this review is to provide a comprehensive summary of key clinical trials concerning the management of lung cancer in the elderly. Furthermore, it underscores the importance of assessing frailty and incorporating Comprehensive Geriatric Assessment (CGA) in the treatment decisions pertaining to older adults with lung cancer. Summary: Numerous clinical trials have investigated the benefits of these treatments in fit older adults, with some trials specifically focusing on geriatric populations. In all cases, the results have shown favorable treatment outcomes. It is essential to assess for frailty and adopt a CGA tool to accurately assess a patient’s suitability for treatment, allowing for a more thorough evaluation of an elderly individual’s functional status and suitability for treatment. This approach not only predicts the tolerability and efficacy of treatment but also serves as a valuable predictor of potential treatment-related toxicities. With the advent of new therapies, there is a greater opportunity to offer treatment to older adults with lung cancer.