The NCI Division of Cancer Prevention in collaboration with the NCI Division of Cancer Treatment and Diagnosis is holding a Cancer Moonshot SM supported virtual meeting to discuss recommendations to enhance accrual of older adults to NCI sponsored clinical trials with a focus on trial design, gaps in the use of geriatric assessment in clinical research, infrastructure needed to enhance accrual, and engagement of key stakeholders. Participants will include oncologists, geriatricians, statisticians, clinical trialists, clinicians, and patient advocates.
Age is the greatest risk factor for developing cancer, though participation in clinical trials does not reflect this. Care providers are often challenged when determining whether an older patient is “fit” to receive standard therapy as part of routine care or to enroll onto a trial. Age biases exists which in routine care can lead to under-treatment of older patients and in clinical research, reduce opportunities for participation. There is a critical need to develop an approach to objectively determine fitness of older adults to participate in clinical trials beyond standard eligibility criteria. Further, there is a high need to develop interventions to address barriers to enrolling older adults to clinical trials. The increase in older adult participation in clinical trials will improve their access to state-of-the-art supportive care and care delivery interventions and improve the safety of receiving treatment regimens once they are FDA approved.
- Identify modifiable barriers to participation of older patients in clinical trials, with emphasis on clinician bias, and develop actionable interventions to address them.
- Build consensus around the best approach and measures to define “fitness”/frailty, including how this might be different in clinical research and routine care.
- Develop a broader research plan to guide the implementation of geriatric assessment in future NCI-supported clinical trials to address gaps in research.