Vulnerable and frail elderly: An approach to the management of the main tumour types

In dealing with older cancer patients undergoing chemotherapy, some form of geriatric evaluation is needed to distinguish those which can be treated as adults from those – the vulnerable ones – who need a modified approach and also from those who are frail or too sick to receive an active treatment. Only scarce data are available to guide treatment of vulnerable or frail patients, the neglected majority of older cancer patients. In most of these cases they receive an adapted approach which does not derive from the results of clinical trials, but from an enlightened empiricism. In this article we summarise and discuss available data for management of the main tumour types in frail and vulnerable patients, and call for further research in this field.