Skip to main content Accessibility help
  • Print publication year: 2010
  • Online publication date: August 2011

Chapter 11 - Management of colon and rectal cancer in older adults

from Part 2 - Management of solid tumors in older adults
Papamichael, D, Audisio, R, Horiot, JC. Treatment of the elderly colorectal cancer patient: SIOG expert recommendations. Ann Oncol. 2009;20(1):5–16.
Sargent, DJ, Goldberg, RM, Jacobson, SD. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med. 2001;345(15):1091–1097.
Jemal, A, Siegel, R, Ward, E. Cancer statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96.
Donald, JJ, Burhenne, HJ. Colorectal cancer: can we lower the death rate in the 1990s?Can Fam Physician. 1993;39:107–114.
,National Cancer Institute homepage. Available at:
Raftery, L, Sanoff, HK, Goldberg, R. Colon cancer in older adults. Semin Oncol. 2008;35(6): 561–568.
Kohne, CH, Folprecht, G, Goldberg, RM. Chemotherapy in elderly patients with colorectal cancer. Oncologist. 2008;13(4):390–402.
Gramont, A, Figer, A, Seymour, M. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000;18(16): 2938–2947.
Saltz, LB, Cox, JV, Blanke, C. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med. 2000;343(13):905–914.
Arkenau, HT, Chua, YJ, Cunningham, D. Current treatment strategies in elderly patients with metastatic colorectal cancer. Clin Colorectal Cancer. 2007;6(7):508–515.
Trimble, EL, Carter, CL, Cain, D. Representation of older patients in cancer treatment trials. Cancer. 1994;74(7 suppl): 2208–2214.
Townsley, CA, Selby, R, Siu, LL. Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. J Clin Oncol. 2005;23(13):3112–3124.
Shayne, M, Culakova, E, Poniewierski, MS. Dose intensity and hematologic toxicity in older cancer patients receiving systemic chemotherapy. Cancer. 2007;110(7):1611–1620.
Brenner, H, Gondos, A, Arndt, V. Recent major progress in long-term cancer patient survival disclosed by modeled period analysis. J Clin Oncol. 2007;25(22):3274–3280.
Bouvier, AM, Launoy, G, Lepage, C. Trends in the management and survival of digestive tract cancers among patients aged over 80 years. Ailment Pharmacol Ther. 2005;22:233–241.
Sanoff, HK, Bleiberg, H, Goldberg, RM. Managing older patients with colorectal cancer. J Clin Oncol. 2007;25(14):1891–1897.
Balducci, L, Tam-McDevitt, J, Hauser, R. Long overdue: phase II studies in older cancer patients: where does the FDA stand?J Clin Oncol. 2008; 26(8):1387–1388.
Losey, R, Messinger-Rapport, BJ. At what age should we discontinue colon cancer screening in the elderly?Cleve Clin J Med. 2007;74(4):269–272.
Smith, RA, Eschenbach, AC, Wender, R. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001 – testing for early lung cancer detection. CA Cancer J Clin. 2001;51(1):38–75; quiz 77–80.
Screening for colorectal cancer: recommendation and rationale. Ann Intern Med. 2002;137(2): 129–131.
,Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149(9):627–637.
Smith, RA, Cokkinides, V, Brawley, OW. Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2009;59(1):27–41.
Chen, X, White, MC, Peipins, . Increase in screening for colorectal cancer in older Americans: results from a national survey. J Am Geriatr Soc. 2008;56(8):1511–1516.
Parks, SM, Hsieh, C. Preventive health care for older patients. Prim Care. 2002;29(3):599–614.
Walter, LC, Lewis, CL, Barton, MB. Screening for colorectal, breast, and cervical cancer in the elderly: a review of the evidence. Am J Med. 2005;118(10):1078–1086.
Pasetto, LM, Monfardini, S. Colorectal cancer screening in elderly patients: when should be more useful?Cancer Treat Rev. 2007;33(6): 528–532.
Lin, OS, Kozarek, RA, Schembre, DB. Screening colonoscopy in very elderly patients: prevalence of neoplasia and estimated impact on life expectancy. J Am Med Assoc. 2006;295(20): 2357–2365.
Gatto, NM, Frucht, H, Sundararajan, V. Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. J Natl Cancer Inst. 2003;95(3):230–236.
Stryker, SJ, Wolff, BG, Culp, CE. Natural history of untreated colonic polyps. Gastroenterology. 1987;93(5):1009–1013.
Walter, LC, Covinsky, KE. Cancer screening in elderly patients: a framework for individualized decision making. J Am Med Assoc. 2001;285(21): 2750–2756.
Duncan, JE, Sweeney, WB, Trudel, JL. Colonoscopy in the elderly: low risk, low yield in asymptomatic patients. Dis Colon Rectum. 2006;49(5):646–651.
Meulenbeld, HJ, Creemers, GJ. First-line treatment strategies for elderly patients with metastatic colorectal cancer. Drugs Aging. 2007;24(3): 223–238.
Arbman, G, Nilsson, E, Storgren-Fordell, V. Outcome of surgery for colorectal cancer in a defined population in Sweden from 1984 to 1986. Dis Colon Rectum. 1995;38(6):645–650.
Damhuis, RA, Wereldsma, JC, Wiggers, T. The influence of age on resection rates and postoperative mortality in 6457 patients with colorectal cancer. Int J Colorectal Dis. 1996;11(1): 45–48.
Surgery for colorectal cancer in elderly patients: a systematic review. Colorectal Cancer Collaborative Group. Lancet. 2000;356(9234): 968–974.
Puig-La Calle, Jr J, Quayle, J, Thaler, HT. Favorable short-term and long-term outcome after elective radical rectal cancer resection in patients 75 years of age or older. Dis Colon Rectum. 2000;43(12):1704–1709.
Basili, G, Lorenzetti, L, Biondi, G. Colorectal cancer in the elderly: is there a role for safe and curative surgery?ANZ J Surg. 2008;78(6):466–470.
Schiffmann, L, Ozcan, S, Schwarz, F. Colorectal cancer in the elderly: surgical treatment and long-term survival. Int J Colorectal Dis. 2008;23(6):601–610.
Zingmond, D, Maggard, M, O';Connell, J. What predicts serious complications in colorectal cancer resection?Am Surg. 2003;69(11):969–974.
Chiappa, A, Zbar, AP, Bertani, E. Surgical outcomes for colorectal cancer patients including the elderly. Hepatogastroenterology. 2001;48(38): 440–444.
Manfredi, S, Bouvier, AM, Lepage C, et al . Incidence and patterns of recurrence after resection for cure of colonic cancer in a well defined population. Br J Surg. 2006;93(9): 1115–1122.
Fallahzadeh, H, Mays, ET. Preexisting disease as a predictor of the outcome of colectomy. Am J Surg. 1991;162(5):497–498.
Mazzoni, G, Tocchi, A, Miccini, M. Surgical treatment of liver metastases from colorectal cancer in elderly patients. Int J Colorectal Dis. 2007;22(1):77–83.
Menon, KV, Al-Mukhtar, A, Aldouri, A. Outcomes after major hepatectomy in elderly patients. J Am Coll Surg. 2006;203(5):677–683.
Liguori Carino, N, Leeuwen, BL, Ghaneh, P. Liver resection for colorectal liver metastases in older patients. Crit Rev Oncol Hematol. 2008;67(3):273–278.
Temple, LK, Hsieh, L, Wong, WD. Use of surgery among elderly patients with stage IV colorectal cancer. J Clin Oncol. 2004;22(17): 3475–3484.
Audisio, RA, Pope, D, Ramesh, HS. Shall we operate? Preoperative assessment in elderly cancer patients (PACE) can help. A SIOG surgical task force prospective study. Crit Rev Oncol Hematol. 2008;65(2):156–163.
Pope, D, Ramesh, H, Gennari, R. Pre-operative assessment of cancer in the elderly (PACE): a comprehensive assessment of underlying characteristics of elderly cancer patients prior to elective surgery. Surg Oncol. 2006;15(4):189–197.
Zampino, MG, Labianca, R, Beretta, GD. Rectal cancer. Crit Rev Oncol Hematol. 2009;70(2):160–182.
Minsky, BD, Cohen, AM, Kemeny, N. The efficacy of preoperative 5-fluorouracil, high-dose leucovorin, and sequential radiation therapy for unresectable rectal cancer. Cancer. 1993;71(11): 3486–3492.
Minsky, BD.Preoperative combined modality treatment for rectal cancer. Oncology. 1994;8(5):53–58, 61; discussion 61, 64–68.
,Improved survival with preoperative radiotherapy in resectable rectal cancer. Swedish Rectal Cancer Trial. N Engl J Med. 1997;336(14):980–987.
Dharma-Wardene, MW, Gara, C, Au, HJ. Ageism in rectal carcinoma? Treatment and outcome variations. Int J Gastrointest Cancer. 2002;32(2–3):129–138.
Folkesson, J, Birgisson, H, Pahlman, L. Swedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol. 2005;23(24): 5644–5650.
O';Connell, JB, Maggard, MA, Liu, JH. Are survival rates different for young and older patients with rectal cancer?Dis Colon Rectum. 2004;47(12):2064–2069.
Marijnen, CA, Kapiteijn, E, Velde, CJ. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer: report of a multicenter randomized trial. J Clin Oncol. 2002;20(3):817–825.
Radu, C, Berglund, A, Pahlman, L. Short-course preoperative radiotherapy with delayed surgery in rectal cancer – a retrospective study. Radiother Oncol. 2008;87(3):343– 349.
Widder, J, Herbst, F, Dobrowsky, W. Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II). Br J Cancer. 2005;92(7): 1209–1214.
Thirion, P, Michiels, S, Pignon, JP. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: an updated meta-analysis. J Clin Oncol. 2004;22(18):3766–3775.
,NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. J Am Med Assoc. 1990;264(11):1444–1450.
Moertel, CG, Fleming, TR, Macdonald, JS. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990;322(6):352–358.
Andre, T, Boni, C, Mounedji-Boudiaf, L. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. 2004;350(23):2343–2351.
Ayanian, JZ, Zaslavsky, AM, Fuchs, CS. Use of adjuvant chemotherapy and radiation therapy for colorectal cancer in a population-based cohort. J Clin Oncol. 2003;21(7):1293–1300.
Jessup, JM, Stewart, A, Greene, FL. Adjuvant chemotherapy for stage III colon cancer: implications of race/ethnicity, age, and differentiation. J Am Med Assoc. 2005;294(21): 2703–2711.
Schrag, D, Cramer, LD, Bach, PB. Age and adjuvant chemotherapy use after surgery for stage III colon cancer. J Natl Cancer Inst. 2001;93(11): 850–857.
Etzioni, DA, El-Khoueiry, AB, Beart, Jr RW.Rates and predictors of chemotherapy use for stage III colon cancer: a systematic review. Cancer. 2008;113(12):3279–3289.
Gross, CP, McAvay, GJ, Guo, Z. The impact of chronic illnesses on the use and effectiveness of adjuvant chemotherapy for colon cancer. Cancer. 2007;109(12):2410–2419.
Dobie, SA, Baldwin, LM, Dominitz, JA. Completion of therapy by Medicare patients with stage III colon cancer. J Natl Cancer Inst. 2006;98(9):610–619.
Arias, E.United States life tables, 2004. Natl Vital Stat Rep. 2007;56(9):1–39.
Muss, HB, Biganzoli, L, Sargent, DJ. Adjuvant therapy in the elderly: making the right decision. J Clin Oncol. 2007;25(14):1870–1875.
Haller, DG, Catalano, PJ, MacDonald, JS. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol. 2005;23(34):8671–8678.
,Quasar Collaborative Group, Gray, R, Barnwell, J. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007;370(9604):2020–2029.
Gill, S, Loprinzi, CL, Sargent, DJ. Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much?J Clin Oncol. 2004;22(10):1797–1806.
Fata, F, Mirza, A, Craig, G. Efficacy and toxicity of adjuvant chemotherapy in elderly patients with colon carcinoma: a 10-year experience of the Geisinger Medical Center. Cancer. 2002;94(7):1931–1938.
Popescu, RA, Norman, A, Ross, PJ. Adjuvant or palliative chemotherapy for colorectal cancer in patients 70 years or older. J Clin Oncol. 1999;17(8): 2412–2418.
Sundararajan, V, Mitra, N, Jacobson, JS. Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Intern Med. 2002;136(5):349–357.
Iwashyna, TJ, Lamont, EB. Effectiveness of adjuvant fluorouracil in clinical practice: a population-based cohort study of elderly patients with stage III colon cancer. J Clin Oncol. 2002;20(19):3992–3998.
O';Connell, MJ, Laurie, JA, Kahn, M. Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer. J Clin Oncol. 1998;16(1):295–300.
Neugut, AI, Matasar, M, Wang, X. Duration of adjuvant chemotherapy for colon cancer and survival among the elderly. J Clin Oncol. 2006;24(15):2368–2375.
Twelves, C, Wong, A, Nowacki, MP. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005;352(26): 2696–2704.
Diaz-Rubio, E.New chemotherapeutic advances in pancreatic, colorectal, and gastric cancers. Oncologist. 2004;9(3):282–294.
Poole, C, Gardiner, J, Twelves, C. Effect of renal impairment on the pharmacokinetics and tolerability of capecitabine (Xeloda) in cancer patients. Cancer Chemother Pharmacol. 2002;49(3):225–234.
Camidge, R, Reigner, B, Cassidy, J. Significant effect of capecitabine on the pharmacokinetics and pharmacodynamics of warfarin in patients with cancer. J Clin Oncol. 2005;23(21):4719–4725.
Shah, HR, Ledbetter, L, Diasio, R. A retrospective study of coagulation abnormalities in patients receiving concomitant capecitabine and warfarin. Clin Colorectal Cancer. 2006;5(5):354–358.
Yood, MU, Quesenberry, CP, Alford, SH. An observational study examining the impact of capecitabine on warfarin antithrombotic activity and bleeding complications. Curr Med Res Opin. 2006;22(2):307–314.
Goldberg, RM, Tabah-Fisch, I, Bleiberg, H. Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. J Clin Oncol. 2006;24(25):4085–4091.
McKibbin, T, Frei, CR, Grene, RE. Disparities in the use of chemotherapy and monoclonal antibody therapy for elderly advanced colorectal cancer patients in the community oncology setting. Oncologist. 2008;13(8):876–885.
Simmonds, PC.Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis. Colorectal Cancer Collaborative Group. Br Med J. 2000;321(7260): 531–535.
Folprecht, G, Cuningham, D, Ross, P. Efficacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials. Ann Oncol. 2004;15(9):1330–1338.
Daniele, B, Rosati, G, Tambaro, R. First-line chemotherapy with fluorouracil and folinic acid for advanced colorectal cancer in elderly patients: a phase II study. J Clin Gastroenterol. 2003;36(3): 228–233.
Mattioli, R, Lippe, P, Recchia, F. Advanced colorectal cancer in elderly patients: tolerance and efficacy of leucovorin and fluorouracil bolus plus continuous infusion. Anticancer Res. 2001;21(1A): 489–492.
Cunningham, D, Pyrhonen, S, James, RD. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet. 1998;352(9138):1413–1418.
Rougier, P, Cutsem, E, Bajetta, E. Randomised trial of irinotecan versus fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer. Lancet. 1998;352(9138):1407–1412.
Rothenberg, ML, Cox, JV, DeVore, RF. A multicenter, phase II trial of weekly irinotecan (CPT-11) in patients with previously treated colorectal carcinoma. Cancer. 1999;85(4): 786–795.
Chau, I, Norman, AR, Chunningham, D. Elderly patients with fluoropyrimidine and thymidylate synthase inhibitor-resistant advanced colorectal cancer derive similar benefit without excessive toxicity when treated with irinotecan monotherapy. Br J Cancer. 2004;91(8):1453– 1458.
Rosati, G, Cordio, S. Single-agent irinotecan as second-line weekly chemotherapy in elderly patients with advanced colorectal cancer. Tumori. 2006;92(4):290–294.
Fuchs, C, Mitchell, EP, Hoff, PM. Irinotecan in the treatment of colorectal cancer. Cancer Treat Rev. 2006;32(7):491–503.
Fuchs, CS, Marshall, J, Mitchelle, E. Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: results from the BICC-C Study. J Clin Oncol. 2007;25(30):4779–4786.
Goldberg, RM, Sargent, DJ, Morton, RF. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol. 2004;22(1):23–30.
Folprecht, G, Seymour, MT, Saltz, L. Irinotecan/fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer: combined analysis of 2,691 patients in randomized controlled trials. J Clin Oncol. 2008;26(9):1443–1451.
Sastre, J, Marcuello, E, Masutti, B. Irinotecan in combination with fluorouracil in a 48-hour continuous infusion as first-line chemotherapy for elderly patients with metastatic colorectal cancer: a Spanish Cooperative Group for the Treatment of Digestive Tumors study. J Clin Oncol. 2005;23(15):3545–3551.
Souglakos, J, Pallis, A, Kakolyris, S. Combination of irinotecan (CPT-11) plus 5-fluorouracil and leucovorin (FOLFIRI regimen) as first line treatment for elderly patients with metastatic colorectal cancer: a phase II trial. Oncology. 2005;69(5):384–390.
Mitry, E, Douillard, JY, Cutsem, E. Predictive factors of survival in patients with advanced colorectal cancer: an individual data analysis of 602 patients included in irinotecan phase III trials. Ann Oncol. 2004;15(7):1013– 1017.
Douillard, JY, Cunningham, D, Roth, AD. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet. 2000;355(9209): 1041–1047.
Kohne, CH, Cutsem, E, Wils, J. Phase III study of weekly high-dose infusional fluorouracil plus folinic acid with or without irinotecan in patients with metastatic colorectal cancer: European Organisation for Research and Treatment of Cancer Gastrointestinal Group Study 40986. J Clin Oncol. 2005;23(22):4856– 4865.
Jong, FA, Kehrer, DF, Mathijssen, RH. Prophylaxis of irinotecan-induced diarrhea with neomycin and potential role for UGT1A128 genotype screening: a double-blind, randomized, placebo-controlled study. Oncologist. 2006;11(8): 944–954.
Park, SB, Goldstein, D, Lin, CS. Acute abnormalities of sensory nerve function associated with oxaliplatin-induced neurotoxicity. J Clin Oncol. 2009;27(8):1243–1249.
Pasetto, LM, D';Andrea, MR, Rossi, E. Oxaliplatin-related neurotoxicity: how and why?Crit Rev Oncol Hematol. 2006;59(2):159–168.
Rothenberg, ML, Oza, AM, Bigelow, RH. Superiority of oxaliplatin and fluorouracil-leucovorin compared with either therapy alone in patients with progressive colorectal cancer after irinotecan and fluorouracil-leucovorin: interim results of a phase III trial. J Clin Oncol. 2003;21(11): 2059–2069.
Figer, A, Perez-Staub, N, Carola, E. FOLFOX in patients aged between 76 and 80 years with metastatic colorectal cancer: an exploratory cohort of the OPTIMOX1 study. Cancer. 2007;110(12):2666–2671.
Mattioli, R, Massacesi, C, Recchia, F. High activity and reduced neurotoxicity of bi-fractionated oxaliplatin plus 5-fluorouracil/leucovorin for elderly patients with advanced colorectal cancer. Ann Oncol. 2005;16(7): 1147–1151.
Kim, JH, Oh, DY, Kim, YJ. Reduced dose intensity FOLFOX-4 as first line palliative chemotherapy in elderly patients with advanced colorectal cancer. J Kor Med Sci. 2005;20(5): 806–810.
Feliu, J, Escudero, P, Llosa, F. Capecitabine as first-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study. J Clin Oncol. 2005;23(13):3104–3111.
Cassidy, J, Twelves, C, Cutsem, E. First-line oral capecitabine therapy in metastatic colorectal cancer: a favorable safety profile compared with intravenous 5-fluorouracil/leucovorin. Ann Oncol. 2002;13(4):566–575.
Golfinopoulos, V, Pentheroudakis, G, Pavlidis, N. Treatment of colorectal cancer in the elderly: a review of the literature. Cancer Treat Rev. 2006;32(1):1–8.
Cassidy, J, Clarke, S, Diaz-Rubio, E. Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol. 2008;26(12):2006–2012.
Feliu, J, Salud, A, Escudero, P. XELOX (capecitabine plus oxaliplatin) as first-line treatment for elderly patients over 70 years of age with advanced colorectal cancer. Br J Cancer. 2006;94(7):969–975.
Seymour, MT, Maughan, TS, Wasan, HS. Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: the FOCUS2 trial [abstract]. J Clin Oncol. 2007;25(suppl):9030.
Bouchahda, M, Macarulla, T, Spano, JP. Cetuximab efficacy and safety in a retrospective cohort of elderly patients with heavily pretreated metastatic colorectal cancer. Crit Rev Oncol Hematol. 2008; 67(3):255–262.
Cunningham, D, Humblet, Y, Siena, S. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med. 2004;351(4): 337–345.
Saltz, LB, Meropol, NJ, Loehrer, PJ. Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol. 2004;22(7): 1201–1208.
Jonker, DJ, O';Callaghan, CJ, Karapetis, CS. Cetuximab for the treatment of colorectal cancer. N Engl J Med. 2007;357(20):2040–2048.
Bouchahda, M, Macarulla, T, Spano, JP. Cetuximab efficacy and safety in a retrospective cohort of elderly patients with heavily pretreated metastatic colorectal cancer. Crit Rev Oncol Hematol. 2008;67(3):255–262.
Amado, RG, Wolf, M, Peeters, M. Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol. 2008;26(10):1626–1634.
Kabbinavar, FF, Hambleton, J, Mass, RD. Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol. 2005;23(16): 3706–3712.
Scappaticci, FA, Skillings, JR, Holden, SN. Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst. 2007;99(16): 1232–1239.
Kabbinavar, FF, Hurwitz, HI, Yi, J. Addition of bevacizumab to fluorouracil-based first-line treatment of metastatic colorectal cancer: pooled analysis of cohorts of older patients from two randomized clinical trials. J Clin Oncol. 2009;27(2):199–205.
Hochster, HS, Hart, LL, Ramanathan, RK. Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer: results of the TREE Study. J Clin Oncol. 2008;26(21):3523–3529.
Elkin, EB, Kim, SH, Casper, ES. Desire for information and involvement in treatment decisions: elderly cancer patients'; preferences and their physicians'; perceptions. J Clin Oncol. 2007;25(33):5275–5280.
Balducci, L.Aging, frailty, and chemotherapy. Cancer Control. 2007;14(1):7–12.
Lichtman, SM, Balducci, L, Aapro, M. Geriatric oncology: a field coming of age. J Clin Oncol. 2007;25(14):1821–1823.
Lichtman, SM.Pharmacokinetics and pharmacodynamics in the elderly. Clin Adv Hematol Oncol. 2007;5(3):181–182.
Mohile, SG, Lachs, M, Dale, W. Management of prostate cancer in the older man. Semin Oncol. 2008;35(6):597–617.
Fried, LP, Ferrucci, L, Darer, J. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A. 2004;59(3):255–263.
Saliba, D, Elliott, M, Rubenstein, LZ. The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49(12):1691–1699.