SynthesisJournal of the National Comprehensive Cancer Network : JNCCN2022
Representation and Outcomes of Older Adults in Practice-Changing Oncology Trials in the Era of Novel Therapies: A Guideline Appraisal.
Synthesis in Journal of the National Comprehensive Cancer Network : JNCCN, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019.BMC geriatrics · 2023Pooled it
- Review
- Clinical outcomes of sacituzumab govitecan in older patients with metastatic triple-negative breast cancer: a multinational real-world study.The oncologist · 2026Article
- [Heterogeneity of Response to PD-1/PD-L1 Inhibitors in Elderly Patients with Advanced NSCLC under the Background of Immunosenescence and Intervention Strategies].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
- Safety profile of ipilimumab in elderly patients: a disproportionate analysis based on the FDA Adverse Event Reporting System database.Frontiers in oncology · 2026Article
- Closing the evidence gap in older adults with extensive-stage small-cell lung cancer: a CGA-guided, risk-adapted treatment framework.Therapeutic advances in medical oncology · 2026Review
- Elective pelvic nodal irradiation for elderly patients with high-risk prostate cancer: A more patient-oriented approach.Clinical and translational radiation oncology · 2025Article
- Management of lung cancer in older adults.Zeitschrift fur Gerontologie und Geriatrie · 2025Review
- Clinicopathologic and Molecular Characterization of Colorectal Cancer in Patients Aged ≥80 years.Clinical interventions in aging · 2025Article
- Geriatric oncology in LMICs: it is time to mature.BMJ oncology · 2024Article
- Enrollment Success, Factors, and Prediction Models in Cancer Trials (2008-2019).JCO oncology practice · 2023Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundOlder adults account for 70% of cancer-related deaths, but previous studies have shown that they are underrepresented in cancer clinical trials. We sought to analyze the representation and outcomes of older adults in trials conducted in the era of novel targeted therapy and immunotherapy.
methodsWe searched the 2020 NCCN Clinical Practice Guidelines in Oncology and retrieved trials from the past 10 years leading to category 1 recommendations in the first-line metastatic setting for the 5 most common causes of cancer death. We categorized trials by cancer type, single-agent versus multiagent approach, and therapeutic class. We described the percentage of older adults (according to each trial's definition) and used a Mantel-Haenszel random-effects meta-analysis model to compare overall and progression-free survival by age.
resultsWe identified 30 trials consisting of 24,416 patients. Across all trials, 44% of enrolled patients were older adults. Representation of older adults by cancer type within trials was 49% prostate cancer, 38% pancreatic cancer, 37% breast cancer, and 34% non-small cell lung cancer. Representation of older adults also varied by therapeutic class: 20% received immunotherapy, 44% received cytotoxic chemotherapy, 54% received targeted/hormonal therapy, and 34% received combination therapy (P<.001 for all comparisons). For each year since 2010, the percentage of older adults enrolled in trials increased by 1.9%, although this difference was not significant. We observed no difference in overall or progression-free survival between older and younger adults. In our analysis of practice-changing clinical trials, we found that 44% of clinical trial participants were older adults. Trials that included immunotherapy or a combination of therapeutic classes had a lower representation of older adults (<40%).
conclusionsWe found that >40% of patients in practice-changing trials are older adults. Although they remain underrepresented in clinical trials compared with the general population, older adults in practice-changing trials seem to be better represented than in previously reported analyses of cooperative group trials.
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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.