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Frailty/age profile precluding doublet-intensive or triplet chemo: ECOG ≥3, OR (age ≥80 +...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-CRC-FRAILTY-AGE
TypeRed flag
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-CRC
SourcesSRC-ESMO-COLON-2024 SRC-NCCN-COLON-2025

Red Flag Origin

DefinitionFrailty/age profile precluding doublet-intensive or triplet chemo: ECOG ≥3, OR (age ≥80 + Charlson ≥3), OR composite (age ≥75 + albumin <3.0 + ≥2 comorbidities). Triggers de-escalation toward 5-FU/LV mono, capecitabine mono, or best supportive care.
Clinical directionde-escalate
Categoryfrailty-age

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 3
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 80
        },
        {
          "comparator": ">=",
          "finding": "charlson_score",
          "threshold": 3
        }
      ]
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 75
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.0
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

IDEA pooled analysis: 3 mo CAPOX adjuvant non-inferior to 6 mo for low-risk (T1-3 N1) stage III — explicitly designed for elderly / fragile. FOCUS-2 trial: capecitabine ± oxaliplatin in elderly mCRC showed acceptable efficacy with reduced toxicity. BSC alone if PS 4 or organ failure precludes any chemo.

Used By

Algorithms

Indications