Treatment of advanced non-small cell lung cancer in the elderly

Non-small cell lung cancer (NSCLC) represents 80% of primary lung neoplasm's. About 50% of diagnosed NSCLC occur in patients aged over 65 years old. Age is not an exclusion criterium but careful assessment of the performance status of patients should be performed. Short daily functional assessment and comprehensive geriatric assessment in selected patients can be helpful in qualifying to systemic treatment. Results of randomized clinical trials confirm effectiveness of two-drug cisplatin-based chemotherapy in first line treatment of the patients in good performance status. A monotherapy with third-generation drug and - in selected patients - gefitinib treatment is optional. Second-line therapy in elderly is safe and effective. Majority of recommendations are based on retrospective analysis. Randomized prospective elderly-specific NSCLC trials are necessary to practically evaluate role of tests of geriatric assessments and effectiveness of chemotherapy.