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Version 1
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Updates on the Management of Colorectal Cancer in Older Adults
Version 1
: Received: 9 April 2024 / Approved: 9 April 2024 / Online: 10 April 2024 (07:59:50 CEST)
A peer-reviewed article of this Preprint also exists.
O’Donnell, C.D.J.; Hubbard, J.; Jin, Z. Updates on the Management of Colorectal Cancer in Older Adults. Cancers 2024, 16, 1820. O’Donnell, C.D.J.; Hubbard, J.; Jin, Z. Updates on the Management of Colorectal Cancer in Older Adults. Cancers 2024, 16, 1820.
Abstract
Colorectal cancer (CRC) poses a significant global health challenge. Notably, the risk of CRC escalates with age, with the majority of cases occurring in those above the age of 65. Despite recent progress in tailoring treatments for early and advanced CRC, there is a lack of prospective data to guide the management of older patients, who are frequently underrepresented in clinical trials. This article reviews the contemporary landscape of managing older individuals with CRC, highlighting recent advancements and persisting challenges. The role of comprehensive geriatric assessment is explored. Opportunities for treatment escalation/de-escalation, with consideration of the older adult’s fitness level are reviewed in the neoadjuvant, surgical, adjuvant and metastatic settings of colon and rectal cancers. Immunotherapy is shown as an effective option treatment in older adults that have CRC with microsatellite instability. Promising new technologies such as circulating tumor DNA and recent phase III trials adding later line systemic therapy options are discussed. Clinical recommendations based on the data available are summarized. We conclude that deliberate efforts to include older individuals in future colorectal cancer trials are essential to better guide the management of these patients in this rapidly evolving field.
Keywords
Colorectal cancer; Geriatric Oncology; Comprehensive Geriatric Assessment
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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