The Place of Targeted Agents in the Treatment of Elderly Patients with Metastatic Colorectal Cancer

Abstract

Despite the high prevalence of colorectal cancer in a continuously aging population and the substantial advances in the treatment of metastatic disease during the past decade, the treatment of elderly patients with advanced, unresectable or metastatic colorectal cancer is a clearly unmet need. Since older patients are under-represented or even excluded from randomized trials, the evidence that oncologists use as guidance is weak. However, small prospective studies, pooled analyses and observational studies show that combination approaches are safe, efficacious and feasible in the geriatric population with metastatic colorectal cancer. The use of biologic agents targeting angiogenesis and the epidermal growth factor receptor, which have been shown to clearly improve outcomes in multiple prospective trials in patients with advanced colorectal cancer, is a vital component of the aforementioned combination approaches. Herein, we review all available data concerning the management of elderly patients with these agents and underscore the differences between this age subgroup and younger patients.

Colorectal Cancers: An Update on Their Molecular Pathology

“…Colorectal cancers (CRCs) represent a group of molecularly heterogeneous diseases that are characterized by a range of genomic and epigenomic alterations [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Our increasing understanding of the molecular pathological epidemiology of CRCs has enabled us to refine their classification from a heterogeneous group of diseases with variable clinical outcomes into characteristic molecular subtypes, a development that will allow personalized therapies to be implemented and improve the management of patients with CRC [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Knowledge regarding the molecular landscapes of CRCs is rapidly increasing; therefore, this review provides a perspective on recent updates regarding the molecular pathological epidemiology of CRCs.…”

Adherence and/or discontinuation of imatinib mesylate in patients with chronic myeloid leukemia

“…However, no conclusive evidence suggests that age may be a factor involved in adherence to imatinib Efficace et al, 2014). Some studies suggest higher adherence rates among younger patients (StCharles et al, 2009;Jabbour et al, 2012b), while others address that adherence is significantly lower among patients with advanced age, which often deal with chronic diseases, present decreased physical and cognitive activities and are more susceptible to complex treatment regimen due to the disease (Townsley et al;Russo et al, 2013;Matikas et al, 2015). In relation to the stage of the disease, two studies included patients in blast crisis, four in accelerated phase and all studies evaluated the drug therapy in patients in the chronic phase of the disease (Table I).…”