Abstract and Introduction
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.
Introduction
The study of cancer care in the older population is a complex task. The word "complex" derives from the Latin cum plexere, meaning to weave together. In an older person, many interwoven conditions may conspire to reduce life expectancy, the tolerance of stress, and the ability to live independently.[1] Anemia in an older person is an example of such a complexity, because it may be affected by multiple causes, including hemopoietic insufficiency, chronic renal dysfunction, chronic inflammation, and iron deficiency from chronic bleeding and iron malabsorption.[2]
The study of cancer care in the older population must take into account the complexity of aging; therefore, as described in this article, a multipronged approach is needed for this patient population.
Cancer Control. 2014;21(3):215-220. © 2014 H. Lee Moffitt Cancer Center and Research Institute, Inc.
Copyright by H. Lee Moffitt Cancer Center & Research Institute. All rights reserved.
