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ESMO E-Learning: Treatment of Advanced NSCLC in the Elderly: an Update

E-learning video block

This content is for ESMO members only.



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Learning objectives

  • To discuss the management of elderly patients with advanced NSCLC to maximize clinical outcomes
  • To outline the strategy for the use of chemotherapy, targeted therapy, and immunotherapy in elderly patients with advanced NSCLC
  • To summarise the safety and efficacy data clarifying the role of different chemotherapy, targeted agents and immunotherapeutics from recent clinical trials in advanced NSCLC, regarding subgroups of elderly patients 


This E-Learning module is an update of an earlier ESMO module on the treatment of advanced non-small cell lung cancer (NSCLC) in the elderly. However, in terms of content, it represents in many domains a completely new work. The author carefully analyses the recent clinical trials that transformed the care in advanced NSCLC and, although there were no trials specifically organised for the elderly, the author carefully considers results from included subgroups of elderly patients.

Lung cancer is the most common cancer in the world, and the majority of lung cancer patients are above the age of 65 years. The challenging demographics will result in an even higher number of elderly people who will develop lung cancer and will need subsequent cancer treatment and care.

This patient population may suffer from other comorbid conditions or geriatric syndromes, complicating their treatment and care. “Biological" age rather than "chronological" age should guide medical decisions. This module gives a good background in the domain of geriatric assessment in cancer patients, although there is limited evidence regarding its impact on treatment decision making.

There are very few specifically designed clinical trials in this subgroup of patients. While there are some data from randomised trials including fit elderly patients, there is only a limited amount of information regarding vulnerable or frail elderly patients with advanced NSCLC.

This E-learning module summarizes data on anticancer treatments, including novel targeted agents and accompanied biomarkers, as well as immunotherapeutics and the side effects in the elderly NSCLC population, hence it serves as an excellent educational tool for the interpretation of data from clinical studies. While there are little data from elderly-specific trials, the author’s attempt to look at the currently available information from a geriatric oncology perspective in the setting of advanced NSCLC is very much appreciated.

The module also critically discusses currently missing information that would allow the optimal management of this population and would improve the quality of life. For example, there are very few data on therapy in octogenarians. 

This E-learning module is intended for medical oncologists, pulmonologists, geriatric oncologists, and others who are involved in the care of elderly patients with advanced NSCLC.

Declaration of interest

Cesare Gridelli has reported:
Honoraria as Speakers Bureau and Advisory Board member for Eli Lilly, MSD, BMS, Roche and AstraZeneca.

Last update: 23 Mar 2020

This E-Learning module was published in 2017. The CME test expired in 2019. The author provided a module update as PDF presentation in 2020.

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