Enrolment of older adults with cancer in early phase clinical trials-an observational study on the experience in the north west of England
Authors
Gomes, FabioDescamps, Tine
Lowe, Jessica
Little, Martin
Lauste, Rosie
Krebs, Matthew G
Graham, Donna
Thistlethwaite, Fiona C
Carter, Louise
Cook, Natalie
Affiliation
The Christie NHS Foundation Trust, Manchester, UK.Issue Date
2021
Metadata
Show full item recordAbstract
Introduction: older patients represent the majority of cancer patients but are under-represented in trials, particularly early phase clinical trials (EPCTs). Material and methods: observational retrospective study of patients referred for EPCTs (January-December 2018) at a specialist cancer centre in the UK. The primary aim was to analyse the successful enrolment into EPCTs according to age (<65/65+). The secondary aims were to identify enrolment obstacles and the outcomes of enrolled patients. Patient data were analysed at: referral; in-clinic assessment and after successful enrolment. Among patients assessed in clinic, a sample was defined by randomly matching the older cohort with the younger cohort (1:1) by tumour type. Results: 555 patients were referred for EPCTs with a median age of 60 years, of whom 471 were assessed in new patient clinics (38% were 65+). From those assessed, a randomly tumour-matched sample of 318 patients (159 per age cohort) was selected. Older patients had a significantly higher comorbidity score measured by ACE-27 (P < 0.0001), lived closer to the hospital (P = 0.045) and were referred at a later point in their cancer management (P = 0.002). There was no difference in suitability for EPCTs according to age with overall 84% deemed suitable. For patients successfully enrolled into EPCTs, there was no difference between age cohorts (20.1 vs. 22.6% for younger and older, respectively; P = 0.675) and no significant differences in their safety and efficacy outcomes. Discussion: older age did not affect the enrolment into EPCTs. However, the selected minority referred for EPCTs suggests a pre-selection upstream by primary oncologists.Citation
Gomes F, Descamps T, Lowe J, Little M, Lauste R, Krebs MG, et al. Enrolment of older adults with cancer in early phase clinical trials—an observational study on the experience in the north west of England. Age and Ageing . 2021 Jun 9.Journal
Age and AgeingDOI
10.1093/ageing/afab091PubMed ID
34107012Additional Links
https://dx.doi.org/10.1093/ageing/afab091Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1093/ageing/afab091
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