Geriatric Oncology Aims For Clinical Trials

Extract

When it comes to cancer care, the elderly often get short shrift. Deemed too frail to handle the side effects from many cancer drugs, the elderly are poorly represented in clinical trials. Scarce trial data have left physicians unsure of how to best treat the aged—so to be safe, physicians may undertreat.

The tide has started to shift, however. Studies increasingly challenge the notion that the elderly are too weak to handle traditional therapy. Over the past 5 years, research has shown that many elderly patients can tolerate the same treatment regimens administered to younger patients—but physicians must choose carefully. Some elderly patients sail through cancer treatment, whereas others suffer severely from side effects. “It's not chronological age that determines success,” said Ted Trimble, M.D., head of gynecologic cancer therapeutics at the National Cancer Institute in Bethesda, Md. “It's the severity of comorbidities.”

But without evidence, selecting patients has been difficult. To boost research, in 2003 the NCI teamed up with the National Institute on Aging and other branches of the National Institutes of Health to launch a 5-year $25 million initiative. The agencies funded eight research institutions to study factors that affect cancer outcomes in the elderly. The large, collaborative, NIH-funded cancer groups in the United States such as Cancer and Leukemia Group B and Eastern Cooperative Oncology Group have also prioritized geriatric oncology in recent years. Organizations such as the American Society of Clinical Oncology have also started to fund fellowships in geriatric oncology.