Age-Related Clinical Trials of CALGB

Women over 65 years are underrepresented in Cancer and Leukemia Group B (CALGB) breast cancer trials of adjuvant chemotherapy. There is greater participation in older patients with metastatic breast cancer except when toxic regimens are involved. Studies of stage III and IV Hodgkin's disease have shown that patients over 60 years achieved lower response rates, more leucopenia and thrombocytopenia, the shortest median time to recurrence, and the shortest median survival time. In acute myeloid leukemia a series of trials confirmed the disparity between young patients and those over 60 years whose complete response rate seldom exceeds 50%. In an effort to reduce toxicity rather than enhance the cure rate, CALGB showed that administration of GM-CSF after intensive induction chemotherapy was of no benefit in patients over 60 years. The use of G-CSF in acute lymphoblastic leukemia reduced hematologic toxicity and improved clinical outcome.