Organ dysfunction, especially kidney dysfunction creates complexities in dosing anticancer drugs in older, frailer patients. The narrow therapeutic margins of anticancer medicines, the changes in pharmacokinetics and pharmacodynamics due to advanced age, comorbidities / performance status and the lack of inclusion of this patient population in larger clinical trials further adds to the dosing dilemma. Lung patients, often advanced in age with comorbidities and/or heavily pre-treated, are particularly reliant on kidney function for dosing of platinum agents e.g., carboplatin, cisplatin. The recent International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) provides a standardised approach in dosing such patients. How does this guidance translate into clinical practice? What are the advantages and disadvantages of adhering to this guideline in older, frailer lung patients?