The Role of Adjuvant Therapy in the Elderly
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Colorectal cancer is the third commonest cancer and second commonest cancer killer in the USA. With a median age at diagnosis of 72 years, it largely affects the elderly population. However, there is a lack of objective data with which to answer clinically relevant questions regarding adjuvant therapy in the geriatric patient population because mainly younger patients are enrolled in clinical trials. Elderly patients are undertreated in the adjuvant setting owing to multiple factors, including physician decision and patient preference. Older patients have different tumor biology, physiologic factors, and social situations to consider in comparison with younger patients. Thus, geriatric patients require more thorough assessment of their functional status and existing medical conditions as they are at risk of increased toxicities from chemotherapy and their ongoing treatment requires vigilance. Elderly patients do benefit from adjuvant chemotherapy, although subgroup analyses show that many do not derive incremental benefit from the addition of oxaliplatin to 5-fluorouracil therapy.
KeywordsAdjuvant chemotherapy Colon cancer Elderly 5-Fluorouracil Oxaliplatin
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Conflict of Interest
Christina Wu is supported by grants from the National Comprehensive Cancer Network and the American Cancer Society.
Richard M. Goldberg is supported by a grant from Sanofi, has received a consulting fee/honorarium from Sanofi and Bayer, has received support for travel to meetings from Sanofi and Bayer, has received compensation for participating in review activities from Lilly and Pfizer, and has received payment for lectures, including service on speakers bureaus, from Fresenius Kabi, and Yakult.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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