Real-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer

doi:10.4251/wjgo.v12.i6.604

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Jun 15, 2020; 12(6): 604-618
Published online Jun 15, 2020. doi: 10.4251/wjgo.v12.i6.604

Real-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer

Atul Batra, Rodrigo Rigo, Dropen Sheka, Winson Y Cheung

Atul Batra, Rodrigo Rigo, Dropen Sheka, Department of Medicine, Tom Baker Cancer Centre, Calgary, Alberta T2N 1N4, Canada

Winson Y Cheung, Department of Oncology, University of Calgary, Calgary, Alberta T2N 4N2, Canada

Author contributions: Batra A, Rigo R, Sheka D and Cheung WY collected the data and wrote the paper.

Conflict-of-interest statement: Authors declare no conflict of interests for this article.

Corresponding author: Winson Y Cheung, MD, Doctor, Professor, Department of Oncology, University of Calgary, 1331 – 29 Street NW, Calgary, Alberta T2N 4N2, Canada. winson.cheung@ahs.ca

Received: February 24, 2020
Peer-review started: February 24, 2020
First decision: April 9, 2020
Revised: May 8, 2020
Accepted: May 29, 2020
Article in press: May 29, 2020
Published online: June 15, 2020
Processing time: 111 Days and 15.4 Hours

Core Tip

Core tip: Use of adjuvant chemotherapy consisting of fluoropyrimidines with/without oxaliplatin has improved survival outcomes for patients with resected colon cancer, especially in those with stage III disease. However, older adults are often not given the opportunity to benefit from chemotherapy after surgery because undertreatment may occur due to various patient and physician related factors. The issue is further compounded by the limited representation of older adults in clinical trials, resulting in underpowered subgroup analyses that do not provide conclusive answers regarding the utility of adjuvant chemotherapy in the advanced age group. We herein review the role of adjuvant chemotherapy in early stage colon cancer, specifically in the context of the older subpopulation, by focusing on both data from clinical trials and data from real-world evidence sources.