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Systemic therapy for elderly patients with gastrointestinal cancer
Joleen M Hubbard1, Axel Grothey, Daniel J Sargent
1Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
Clinical Medicine Insights. Oncology
|May 24, 2011
Summary
Older adults with gastrointestinal cancers are underrepresented in clinical trials. This review examines chemotherapy effectiveness and tolerability in elderly patients, offering practical guidance for improved outcomes.
Area of Science:
- Oncology
- Geriatric Medicine
- Clinical Pharmacology
Background:
- Gastrointestinal cancers disproportionately affect individuals over 65.
- Older adults are underrepresented in clinical trials, limiting understanding of treatment efficacy and tolerability in this demographic.
- Few studies specifically address the unique needs of elderly patients with gastrointestinal cancers.
Purpose of the Study:
- To review existing evidence on chemotherapeutic regimens for elderly patients with colorectal, pancreatic, and gastroesophageal cancers.
- To evaluate survival benefits and tolerability of treatments in older adults.
- To propose a practical approach for optimizing outcomes in this patient population.
Main Methods:
- Systematic review of published literature on chemotherapy in elderly patients with gastrointestinal cancers.
- Analysis of subset data from individual clinical trials.
- Examination of pooled patient data from multiple trials.
- Review of studies specifically designed for patients over 65 years.
Main Results:
- Evidence suggests variability in treatment outcomes and tolerability among older patients.
- Subset and pooled analyses provide insights into the efficacy of various chemotherapeutic regimens.
- Specific data on treatments tailored for the elderly remains limited.
Conclusions:
- Further research and specifically designed trials are needed to optimize chemotherapy for older adults with gastrointestinal cancers.
- A practical, individualized approach is crucial for managing elderly patients.
- Improving clinical trial representation for older adults is essential for evidence-based geriatric oncology.
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