Optimizing Systemic Therapy in Advanced Gastrointestinal Malignancies: Strategies to Minimize Toxicity and Maximize...

Area of Science:

• Oncology
• Gastroenterology
• Clinical Pharmacology

Background:

• Advanced gastrointestinal cancers present a significant global health burden, with increasing incidence in younger individuals.
• Systemic chemotherapy is the primary treatment, but managing side effects and ensuring tolerability remain key challenges.
• Older adults and those with comorbidities are often underrepresented in trials, necessitating real-world dose adjustments.

Purpose of the Study:

• To review current strategies for optimizing systemic therapy in advanced gastrointestinal cancers.
• To highlight the importance of personalized, patient-centered approaches to treatment.
• To underscore the need for practical care pathways that balance efficacy and tolerability.

Main Methods:

• This is a review article, synthesizing existing evidence and clinical practices.
• Discussion focuses on modifying drug doses and schedules based on patient factors.
• Emphasis is placed on real-world data and clinical experience.

Main Results:

• Personalized systemic therapy, considering age, fitness, and response, can enhance treatment tolerability.
• Modified dosing and frequency show promise in improving patient quality of life.
• Limited prospective data currently exist for many modified approaches.

Conclusions:

• Optimizing systemic therapy for advanced gastrointestinal cancers requires a patient-centered approach.
• Individualized treatment plans are essential for managing toxicity and maintaining quality of life.
• Further prospective research is needed to validate modified dosing strategies.