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How would you treat an older patient with stage IIC nonseminoma who is unfit for platinum chemotherapy due to comorbidities?
Are there any chemotherapy regimens that can be used in elderly patients with poor PS who are not candidates for BEP?
Answer from: Medical Oncologist at Academic Institution
These are difficult questions to answer. The definition of a patient unsuitable for cisplatin in an elderly patient varies from oncologist to oncologist. Cisplatin + etoposide for 4 courses is the “standard“ therapy for patients over the age of 50. For elderly patients with poor performa...
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Answer from: Medical Oncologist at Community Practice
I agree with Dr. @Einhorn. I think his first point is really important. Perhaps you could clarify what constitutes "unfit for chemotherapy" in this patient. For example, if he has renal dysfunction due to urinary obstruction, that can be addressed and would make him "fit" for cisplatin; if he has a ...
Answer from: Medical Oncologist at Academic Institution
I have a similar patient in his 50s with stage III seminoma (good risk) presented with hydronephrosis on the left, stent decompressed collecting system, and creatinine still 1.7 mg/dl, eGFR 47 ml/min. It seems like I'll have to do carboplatin for the first cycle and see where things flesh out as the...