Lodovico Balducci1. 1. Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL 33612, USA. Lodovico.Balducci@Moffitt.org.
Abstract
BACKGROUND: Data relating to cancer treatment in the older patient population are limited because older individuals have been under-represented in clinical trials. The goal of this review was to establish which factors hinder the participation of older individuals to clinical trials and to examine possible solutions. METHODS: The literature relating to cancer treatment in the older patient population was reviewed. RESULTS: The benefit of systemic cancer treatment may decrease with age, and risks may be increased due to reduced life expectancy and reduced tolerance of stress in the older population. Therefore, a multipronged approach is recommended for clinical studies in these patients, including phase 2 studies limited to persons 70 years of age and older, stratification by life expectancy and predicted treatment tolerance in phase 3 studies, and registration studies to establish predictive variables for treatment-related toxicity in older individuals. CONCLUSIONS: A combination of prospective and registration studies may supply adequate information to study cancer treatments in the older patient population.
BACKGROUND: Data relating to cancer treatment in the older patient population are limited because older individuals have been under-represented in clinical trials. The goal of this review was to establish which factors hinder the participation of older individuals to clinical trials and to examine possible solutions. METHODS: The literature relating to cancer treatment in the older patient population was reviewed. RESULTS: The benefit of systemic cancer treatment may decrease with age, and risks may be increased due to reduced life expectancy and reduced tolerance of stress in the older population. Therefore, a multipronged approach is recommended for clinical studies in these patients, including phase 2 studies limited to persons 70 years of age and older, stratification by life expectancy and predicted treatment tolerance in phase 3 studies, and registration studies to establish predictive variables for treatment-related toxicity in older individuals. CONCLUSIONS: A combination of prospective and registration studies may supply adequate information to study cancer treatments in the older patient population.
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