Colorectal cancer (CRC) is a common tumor, and its incidence increases with age. Elderly CRC patients constitute a daily challenge for oncologists when deciding if they are worthy of active treatments and of which kind, as data from the literature are incomplete or even lacking in specific subsets. To fill this gap, we conducted a narrative review that included not only studies dedicated to the elderly but also extracted elderly groups from major clinical trials. Results in terms of harm and benefit were dissected according to frailty categories (fit, vulnerable, unfit). As it emerged, the management of elderly CRC patients should be based not on age alone, but rather on their frailty level, as assessed by Comprehensive Geriatric Assessment (CGA), which should be implemented in trials and clinical practice. Elderly patients should be treated similarly to young patients in the first and subsequent lines, without precluding the use of innovative drugs. Vulnerable elderly individuals should receive personalized schedules that focus more on symptoms and quality of life; for frail patients, supportive care alone is often a valid option.

The therapeutic landscape of advanced and recurrent endometrial cancer (EC) has evolved substantially in recent years due to the integration of molecular classification and novel systemic therapies. This review summarizes current treatment strategies in advanced EC, focusing on immunotherapy, targeted therapies, and molecularly guided approaches. Immune checkpoint inhibitors (ICIs) have become a cornerstone of treatment, particularly in mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) tumors, where durable clinical benefit has been observed. Recent phase III trials demonstrated that the addition of ICIs to platinum-based chemotherapy significantly improves progression-free survival in the first-line setting, especially in dMMR disease, with more modest but clinically meaningful benefit in mismatch repair-proficient (pMMR) tumors. In the post-platinum setting, combinations such as pembrolizumab plus lenvatinib have expanded treatment options for pMMR patients, despite increased toxicity. Advances in molecular profiling, including the ProMisE classification, are increasingly guiding treatment personalization. Emerging therapies, including PARP inhibitors and antibody–drug conjugates targeting HER2 and Trop-2, are showing promising activity. Despite these advances, challenges remain regarding resistance mechanisms, optimal treatment sequencing, and predictive biomarkers beyond MMR status.

The introduction of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) has significantly changed the management of high-risk urological cancers, particularly clear cell renal cell carcinoma and muscle-invasive urothelial carcinoma. This review provides a comprehensive narrative overview of immune-related adverse events (irAEs) associated with adjuvant ICIs, integrating evidence from pivotal registrational trials and real-world clinical experience. Clinical studies and reports were reviewed to characterize the incidence, type, severity, and management of irAEs. Across registrational trials, endocrine, cutaneous, and gastrointestinal toxicities were the most frequently reported irAEs and were predominantly mild to moderate in severity. Severe events were less common and required early recognition and structured management, often including corticosteroids and targeted immunomodulatory therapies. In our real-world cohort, irAEs occurred in 5 of 13 patients (38.5%) receiving adjuvant anti-PD-1 therapy, mainly involving endocrine and cutaneous systems, with a frequency and severity profile consistent with that reported in the KEYNOTE-564 and CheckMate-274 trials. Most irAEs were grades 1–2 according to CTCAE criteria and were manageable with standard treatments; permanent discontinuation of immunotherapy was required in a single case. Overall, the integration of clinical trial data and real-world evidence supports a favourable and manageable safety profile of adjuvant ICIs in high-risk urological cancers. Multidisciplinary management remains essential to optimise patient outcomes.