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ESMO E-Learning:  Management of Colorectal Cancer in Older Adults

New E-Learning module by Dr Papamichael, Dr Gallois and Dr Liposits is now available. Watch the presentation and take the CME test today!

E-learning video block

This content is for ESMO members only.



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Learning objectives

  1. To elaborate key factors and considerations that influence the planning of the management of older patients with colorectal cancer
  2. To contextualise currently available evidence in terms of the adjuvant treatment for older patients with colorectal cancer   
  3. To put in context currently available evidence in terms of the treatment of older patients with metastatic colorectal cancer


In this E-Learning module, the authors tackle controversies regarding the management of older patients, the gap in knowledge between patients included in the randomised trials and real-world population, the importance of in-depth assessment of both, the tumour and the patient, as well as the other factors influencing the care, and contextualise the findings from the trials in the adjuvant and metastatic settings, important for the management of older patients with colorectal cancer.

Starting from the benefit of adjuvant chemotherapy in the general population of patients with colorectal cancer, the authors further elaborate on the benefit of adjuvant chemotherapy in older patients with stage III disease, specifically the benefit from oxaliplatin; they provide findings from a pooled analysis of clinical trials, especially in terms of time-to-recurrence according to age and treatment duration, deep into potential approaches in case of fit and unfit patients for doublet chemotherapy, tackle the prospect of ongoing trials and give details about the findings in stage II colorectal cancer and the pragmatic approach for patients older than 70 years.

In the next chapter, the authors elaborate on how to treat older patients with metastatic colorectal cancer and the findings from clinical trials dedicated to older patients or the analysis from trials that looked into such subset of patients and tested chemotherapy, chemotherapy with or without bevacizumab, EGFR inhibitors, chemotherapy plus EGFR inhibitors, EGFR inhibitor added to doublet chemotherapy; findings from trials in BRAF-mutated metastatic tumours, immune checkpoint inhibitor monotherapy versus chemotherapy, treatment with combined immune checkpoint inhibitors versus chemotherapy, and treatment in third-line setting.

The authors point out that dedicated randomised clinical trials are needed to evaluate the real value of cancer drugs in unselected/vulnerable older adults. They advocate for patient-centred endpoints as (co)-primary endpoint(s), patient stratification based on geriatric assessment and underline that geriatric assessment guided interventions are feasible.

Declaration of interest

Demetris Papamichael has reported:
Financial Interests:
Invited Speaker, Institutional, Advisory Board participation: Merck Serono.
Advisory Board, Institutional: Ipsen, Servier, BMS.
Invited Speaker, Institutional: Ipsen, Amgen, Servier, BMS.
Research Grant, Institutional: MSD.
Non-Financial Interests:
Advisory Role, IDMC member in one of their clinical trials: Servier.
Advisory Role, Member of the Editorial Board: European Journal Of Surgery.
Member of Board of Directors: Cyprus Cancer Research Institute.
Advisory Role, Member of the Scientific Committee: European School of Oncology.
Editorial Board, Other: ESMO GI Journal.
Member, National Representatives Committee: SIOG - International Society of Geriatric Oncology.

Claire Gallois has reported:
Financial Interests:
Invited Speaker, Institutional: Sanofi Genzyme.
Advisory Board, Institutional: Servier.
Other, Institutional, French congress invitation: MSD.
Other, Institutional, Congress invitation: Amgen.

Gabor Liposits has reported:
Financial Interests:
Other, Personal, Received funding for working in an expert panel: Nutricia AS.
Invited Speaker, Personal, Workshop: Servier.
Non-Financial Interests:
Member International Society of Geriatric Oncology (SIOG).

Last update: 30 Apr 2024

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