Systemic Therapy of Common Tumours in Older Patients: Challenges and Opportunities. A Young International Society of Geriatric Oncology Review Paper

Access to early-phase clinical trials in older patients with cancer in France: the EGALICAN-2 study

Background

Patients and methods

Results

Conclusions

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Older patients are underrepresented in early-phase clinical trials (17.7%) compared with the number of new cases (50%).

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The rate of signed informed consent was similar across age groups (92.7% in younger patients versus 90.6% in older patients).

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The rate of screening failure was consistent across all age groups (28.5% in younger patients versus 24.3% in older patients).

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In older patients the initial care received in the center having a phase I unit was associated with study drug administration.

How aging of the global population is changing oncology

Population aging is causing a demographic redistribution with implications for the future of healthcare. How will this affect oncology? First, there will be an overall rise in cancer affecting older adults, even though age-specific cancer incidences continue to fall due to better prevention. Second, there will be a wider spectrum of health functionality in this expanding cohort of older adults, with differences between “physiologically older” and “physiologically younger” patients becoming more important for optimal treatment selection. Third, greater teamwork with supportive care, geriatric, mental health and rehabilitation experts will come to enrich oncologic decision-making by making it less formulaic than it is at present. Success in this transition to a more nuanced professional mindset will depend in part on the development of user-friendly computational tools that can integrate a complex mix of quantitative and qualitative inputs from evidence-based medicine, functional and cognitive assessments, and the personal priorities of older adults.