The management of cancer in the elderly: targeted therapies in oncology
Biagio Agostara*1, Giuseppe Carruba2 and Antonella Usset1
Address: 1Clinical Oncology, Department of Oncology, "M. Ascoli" Cancer Hospital Center, ARNAS-Civico, Palermo, Italy and 2Experimental Oncology, Department of Oncology, "M. Ascoli" Cancer Hospital Center, ARNAS-Civico, Palermo, Italy Email: Biagio Agostara* - email@example.com; Giuseppe Carruba - firstname.lastname@example.org; Antonella Usset - email@example.com * Corresponding author
Published: 30 December 2008 Immunity & Ageing 2008, 5:16 doi:10.1186/1742-4933-5-16
Received: 16 September 2008 Accepted: 30 December 2008
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The most common targeted therapies used in clinical practice, i.e. monoclonal antibodies and small molecules, are described.
Introduction: the ageing and cancer interface
Cancer is generally considered a disease of ageing, although the shared mechanisms underpinning the two processes remain unclear. Doubtlessly, incidence and mortality rates of most human cancers increase consistently with age, but they decline in the oldest old (≥ 90 years). This finding has been interpreted as a consequence of either the exploitation of large-scale population screening programs or the improvement of diagnostic capacities worldwide. However, there is convincing evidence that, regardless of other variables, cancer and aging remain associated until around 85 years of age, while they diverge substantially thereafter.
Recent studies have suggested that either "convergent" or "divergent" mechanisms may connect cancer and aging. In the former, molecular pathways simultaneously provide protection against cancer and resistance to ageing by limiting the generation and accumulation of cellular, genetic or epigenetic, damage. In the latter, some other pathways may eventually lead to protect from cancer but also to promote ageing, including shortening of telomeres and derepression of the INK4a/ARF locus. It ought