Oral anticancer drug administration in older adults: A review of galenic challenges, medication-related risks, and future pharmaceutical perspectives.

Authors

Sara Hajjaj, Ali Cherif Chefchaouni, Safae Alaoui, Seham El Deeb, Soufiane El Marrakchi, Badreddine Moukafih, Fatima-Zahra Bandadi, Younes Rahali, Abdeslam El Kartouti, Ismail Bennani

Published in

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. Pages 10781552261486723. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

ObjectiveTo review the challenges associated with oral anticancer drug administration in older adults, focusing on dysphagia, dosage-form manipulation, medication-related risks, acceptability, and oncology-specific safety considerations.Data SourcesA narrative literature review was conducted using PubMed, Scopus and ScienceDirect. Publications from January 2000 to March 2026 were identified using keywords related to geriatric oncology, dysphagia, oral dosage forms, dosage-form manipulation, oral anticancer agents, medication safety, acceptability, and hazardous drugs. Review articles, original studies, professional recommendations and regulatory documents were included.Data SummarySwallowing disorders are common among older adults with cancer and may compromise oral anticancer therapy administration. Dosage-form manipulation practices, including tablet crushing and capsule opening, are frequently used despite their potential effects on drug stability, bioavailability, pharmacokinetics, and therapeutic efficacy. These concerns are amplified by the narrow therapeutic index of many oral anticancer agents and the risk of occupational, caregiver, and environmental exposure to hazardous drugs. Available evidence reveals gaps in standardized administration procedures and limited data supporting alternative administration strategies. A review of selected oral anticancer agents showed substantial variability in formulation constraints, manipulation practices, and supporting evidence. Emerging approaches, including dispersible and orodispersible formulations, multiparticulate systems, mini-tablets, and three-dimensional (3D) printed medicines, may improve treatment acceptability and reduce inappropriate dosage-form manipulation.ConclusionsDysphagia and dosage-form manipulation remain underrecognized challenges in geriatric oncology, with implications for treatment safety, efficacy, adherence, and hazardous-drug exposure. Addressing these issues requires multidisciplinary collaboration, standardized procedures, patient-centered formulation design, and further research to support evidence-based practice.

PMID:
42706603
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.