Learning to Care for the Older People: An Urgent Need in the Daily Practice of Oncologists

Rosati, Gerardo

doi:10.3390/jcm11113149

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…These patients consist of an extremely varied population of subjects, ranging form fit to frail, characterized by various clinical conditions, few or many comorbidities and different ability to tolerate chemotherapy ( 5 ). The implementation of a multidimensional geriatric assessment (CGA) and accurate tools such as the Geriatric-8 (G8) and the Vulnerable Elders Survey-13 (VES-13) will be able to guide the clinician on a case-by-case basis in his decision-making process ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a phase II randomized trial has demonstrated that the an intermittent therapy based on anti-EGFRs limits toxicity and produces a long PFS without any detrimental effect on OS ( 17 ). This approach could be particularly attractive in pre-treated older patients, especially among those who require adaptive treatment, as in vulnerable subjects to whom many of them belong anyway ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of intermittent panitumumab based-therapy for previously treated older patient with metastatic colorectal cancer: a case report and review of literature

Rosati,

Annunziata,

Scarano

et al. 2024

Front. Oncol.

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BackgroundMetastatic colorectal cancer is one of the most common causes of cancer death worldwide, and its incidence increases with age. Treating an older RAS and BRAF wild-type patient represents a challenge for the medical oncologist, even more so for those patients defined as “vulnerable” and undergoing at least two lines of therapy. In this context, recent evidence supports the role of retreatment with anti-EGFR inhibitors and the use of liquid biopsy. However, frequent skin toxicity constitutes a limitation of therapy, especially in older people. Since it has been described that continuous administration of these monoclonal antibodies leads to acquired resistance to anti-EGFRs, with consequent therapeutic failure, an intermittent strategy with chemotherapy plus an anti-EGFR could help maintain the efficacy of the treatment over time, delaying the resistance and improving patients’ quality of life.Case presentationIn this case report, we describe the case of an older RAS and BRAF wild-type patient reporting a clinical response after first-line chemotherapy with FOLFOX + panitumumab, subsequently interrupted in the absence of disease progression. After radiological worsening and two additional lines of therapy, the reintroduction of panitumumab plus 5-fluorouracil, administered with a stop-and-go strategy, allowed the patient to benefit from the same drugs for 2 years from diagnosis, to achieve a clinical response during fourth-line treatment lasting more than 3 years, to delay resistance and to avoid unacceptable anti-EGFR skin toxicity. This patient, who died from a myocardial infarction more than 5 years after diagnosis, represents the case of a good synergy between molecular profile of disease and reintroduction of an anti-EGFR with intermittent strategy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of intermittent panitumumab based-therapy for previously treated older patient with metastatic colorectal cancer: a case report and review of literature

Rosati,

Annunziata,

Scarano

et al. 2024

Front. Oncol.

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“…On the other hand, patients with poor performace status (PS), loss of autonomy, and various comorbidities are considered to be “frail” patients and they should be excluded from any type of therapy. The majority of older patients, however, fall into a middle range, i.e., that of “vulnerable” subjects, for whom, from time to time, less intensive and adapted therapies could be assigned on a case-by-case basis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

An Update on the Role of Anti-EGFR in the Treatment of Older Patients with Metastatic Colorectal Cancer

Rosati

Montrone

Pacilio

et al. 2022

JCM

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Although colorectal cancer is increasingly being diagnosed in older patients, their number is largely underrepresented in phase II or III clinical trials. Consequently, guidelines and the SIOG recommendations are not sufficiently clear regarding the treatment of these patients, particularly when chemotherapy is combined with monoclonal antibodies (bevacizumab, cetuximab, and panitumumab). Targeted therapy based on the use of anti-epidermal growth factor receptors (EGFRs) is conditioned by the potential for increased toxicity, making it more difficult to treat an older, rat sarcoma virus (RAS) and B rapidly accelerated fibrosarcoma (BRAF) wild-type patient. In light of a more detailed characterization of the older population, modernly differentiable between fit, vulnerable, or frail patients on the basis of the comprehensive geriatric assessment, and of the analysis of more recent studies, this review fully collects data from the literature, differentiating the results on functional status patients.

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Elderly Rectal Cancer: An Updated Review

Huang,

Shih,

Kao

2024

Curr Oncol Rep

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Learning to Care for the Older People: An Urgent Need in the Daily Practice of Oncologists

Abstract: Cancer is the most widespread and prominent health issue worldwide and its incidence is only exceeded by cardiovascular diseases [...]

Cited by 3 publications

References 24 publications

Clinical outcomes of intermittent panitumumab based-therapy for previously treated older patient with metastatic colorectal cancer: a case report and review of literature

Clinical outcomes of intermittent panitumumab based-therapy for previously treated older patient with metastatic colorectal cancer: a case report and review of literature

An Update on the Role of Anti-EGFR in the Treatment of Older Patients with Metastatic Colorectal Cancer

Elderly Rectal Cancer: An Updated Review

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