title: Meta-analysis of molecular targetted agents in the treatment of elderly patients with metastatic colorectal cancer: does the age matter?
abstract: OBJECTIVE
  Patients aged 65 years and older are often under-represented in clinical trials of metastatic colorectal cancer (mCRC) and probably undertreated in clinical practice. We performed a meta-analysis of randomized controlled trials to assess the efficacy of molecular targetted agents (MTAs) in this population.
  
  
  METHODS
  A comprehensive literature search for studies published up to December 2014 was performed. The endpoints were overall survival (OS) and progression-free survival (PFS). The pooled hazard ratio (HR) and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.
  
  
  RESULTS
  Eleven randomized controlled trials involved 8,488 patients were ultimately identified. The pooled analysis demonstrated that the use of MTAs in elderly patients with mCRC significantly improved OS (HR 0.84, 95% CI: 0.76-0.92, p < 0.001) and PFS (HR 0.78, 95% CI: 0.64-0.96, p = 0.017) when compared to MTAs-free therapies. Similar results of OS were observed in sub-group analysis according to treatment line and regimes. No publication bias was detected by Begg's and Egger's tests.
  
  
  CONCLUSIONS
  The introduction of MTAs to therapies offers a survival benefit in elderly patients with mCRC. Further studies aimed at this specific patient population are still needed to monitor potential treatment-related toxicities to optimize the use of these drugs.
authors.affiliation: a Department of Gastrointestinal Surgery , The Second People's Hospital of LiaoCheng , Shandong Province , China.
authors.forename: ChuanJie
authors.initials: C
authors.lastname: Zhao
authors.affiliation: a Department of Gastrointestinal Surgery , The Second People's Hospital of LiaoCheng , Shandong Province , China.
authors.forename: ShuLiang
authors.initials: S
authors.lastname: Li
authors.affiliation: b Department of Surgical Oncology Surgery , The First Hospital of HeBei Medical University , ShiJiaZhuang , China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis
keywords: Advanced colorectal cancer; Elderly; Meta-analysis; Molecular targetted agents; Randomized controlled trials