Open AccessReal-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer
Author(s) -
Atul Batra,
Rodrigo Rigo,
Dropen Sheka,
Winson Y. Cheung
Publication year - 2020
Publication title -
world journal of gastrointestinal oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.924
H-Index - 26
ISSN - 1948-5204
DOI - 10.4251/wjgo.v12.i6.604
Subject(s) - medicine , colorectal cancer , stage (stratigraphy) , clinical trial , oncology , cancer , disease , population , adjuvant chemotherapy , randomized controlled trial , chemotherapy , paleontology , environmental health , breast cancer , biology
Colon cancer represents one of the most common cancers diagnosed in older adults worldwide. The standard of care in resected stage II and stage III colon cancer continues to evolve. While there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer, data regarding its use in patients with stage II colon cancer are less clear. Further, although colon cancer is a disease that affects older adults, there is considerable debate on the value of adjuvant chemotherapy in the aging population. In particular, many older patients are undertreated when compared to their younger counterparts. In this review, we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer, discuss representation of older adults in trials and the specific challenges associated with the management of this sub-population, and highlight the role of comprehensive geriatric assessments. We will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.