SynthesisCA: a cancer journal for clinicians2021
Older adult participation in cancer clinical trials: A systematic review of barriers and interventions.
Synthesis in CA: a cancer journal for clinicians, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 298 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
298 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Inclusion, characteristics, and reporting of older patients in recent registration trials for DLBCL.Blood advances · 2026Pooled it
- Updated systematic review and meta-analysis: taking the next step in physical activity behavioral interventions for post-treatment breast cancer survivors.Breast cancer research and treatment · 2026Pooled it
- Pooled it
- Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review.Journal of cancer survivorship : research and practice · 2025Pooled it
- Lenvatinib plus pembrolizumab for untreated advanced renal cell carcinoma: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2024Pooled it
- 6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7).Breast (Edinburgh, Scotland) · 2024Guideline
- Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Guideline
- Pooled it
- Temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019.BMC geriatrics · 2023Pooled it
- Sarcopenia Is Associated With Severe Treatment Toxicity and Mortality in Older Adults With Advanced Cancer: A Secondary Analysis.Journal of cachexia, sarcopenia and muscle · 2026Trial
- Outcomes of Older Adults With Advanced Cancer Who Prefer Quality of Life vs Prolonging Survival: A Secondary Analysis of the GAP70+ Cluster Randomized Clinical Trial.JAMA oncology · 2026Trial
- HER2DX in older patients with HER2-positive early breast cancer: extended follow-up from the RESPECT trial of trastuzumab ± chemotherapy.Nature communications · 2025Trial
- Physical activity and mobility disability in older adult cancer survivors.JNCI cancer spectrum · 2025Trial
- Motivation toward physical activity and nutrition in older cancer patients: the MONAGE protocol using ecological momentary assessment and accelerometers.BMC geriatrics · 2025Trial
- NHS-Galleri trial: Enriched enrolment approaches and sociodemographic characteristics of enrolled participants.Clinical trials (London, England) · 2025Trial
- Exploring geriatric assessment-driven rehabilitation referral patterns and its influence on functional outcomes and survival in older adults with advanced cancer.Journal of the American Geriatrics Society · 2025Trial
- Palbociclib in adults aged 70 years and older with advanced breast cancer: A phase 2 multicenter trial (Alliance A171601).Journal of geriatric oncology · 2024Trial
- Primary Treatment Modification and Treatment Tolerability Among Older Chemotherapy Recipients With Advanced Cancer.JAMA network open · 2024Trial
- The effect of older age and stage on risk of recurrence and mortality following curative resection, in a national cohort of patients with colorectal cancer.British journal of cancer · 2026Article
- The immunology of human breast cancer.Nature reviews. Immunology · 2026Review
238 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
Abstract
Cancer is a disease of aging and, as the world's population ages, the number of older persons with cancer is increasing and will make up a growing share of the oncology population in virtually every country. Despite this, older patients remain vastly underrepresented in research that sets the standards for cancer treatments. Consequently, most of what we know about cancer therapeutics is based on clinical trials conducted in younger, healthier patients, and effective strategies to improve clinical trial participation of older adults with cancer remain sparse. For this systematic review, the authors evaluated published studies regarding barriers to participation and interventions to improve participation of older adults in cancer trials. The quality of the available evidence was low and, despite a literature describing multifaceted barriers, only one intervention study aimed to increase enrollment of older adults in trials. The findings starkly amplify the paucity of evidence-based, effective strategies to improve participation of this underrepresented population in cancer trials. Within these limitations, the authors provide their opinion on how the current cancer research infrastructure must be modified to accommodate the needs of older patients. Several underused solutions are offered to expand clinical trials to include older adults with cancer. However, as currently constructed, these recommendations alone will not solve the evidence gap in geriatric oncology, and efforts are needed to meet older and frail adults where they are by expanding clinical trials designed specifically for this population and leveraging real-world data.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.