, Volume 29, Issue 6, pp 1515-1516
Date: 16 Dec 2010

Letter to the editor: “Phase II trial of S-1 monotherapy in elderly or frail patients with metastatic colorectal cancer”

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Dear Sir:

We read with great interest the article “Phase II trial of S-1 monotherapy in elderly or frail patients with metastatic colorectal cancer”, published in Investigational New Drugs 2010 (doi:10.1007/s10637-010-9418-2). We would like to make a few comments.

Although it is a very interesting article examining the activity of S-1 monotherapy in elderly patients with colorectal cancer, the authors did not use a standardized definition of frailty. Specifically, in this study, a patient was considered frail merely on the basis of a score of at least 2 on the ECOG (Eastern Cooperative Oncology Group) PS (performance status) scale.

It is unacceptable to present a series without clearly stating the patients’ cancer stage. The TNM staging system is fundamental to the development of treatment plans and for drafting guidelines. Similarly, a study of elderly patients cannot be justified without the generation of accurate data that assess the levels of frailty. Frailty is a sensitive indicator