Anticancer drugs are not well tolerated in all older patients with cancer
Hans Wildiers1, Nienke A de Glas2
1Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
Abstract:
Studies on new anticancer drugs often inappropriately conclude that these treatments are well tolerated and feasible in the older population with cancer, despite the drug being investigated in only a selection of healthy older patients who are not representative of the true older population. In this Personal View we outline examples of reports that provide misleading information to clinicians, mostly because the tolerance and efficacy were not assessed according to frailty status and only a few people who are frail were included. We also provide solutions on how to inform clinicians, patients, and health authorities more clearly about the benefits and disadvantages of new and upcoming anticancer drugs for older people with cancer.
Insights
New anticancer drug studies often mislead by not assessing tolerance and efficacy in frail older cancer patients. Clearer reporting is needed to inform decisions for this vulnerable population.
Area of Science:
- Geriatric Oncology
- Clinical Pharmacology
- Cancer Therapeutics
Background:
- Anticancer drug trials frequently include limited, healthy older adults, not representative of the broader geriatric population.
- Current assessments of drug tolerance and efficacy in older adults often neglect frailty status, leading to potentially misleading conclusions.
Purpose of the Study:
- To highlight the issue of inadequate representation of frail older adults in anticancer drug trials.
- To propose solutions for clearer communication of benefits and risks of novel anticancer drugs for older cancer patients.
Main Methods:
- Analysis of existing reports on new anticancer drug studies in older populations.
- Identification of common shortcomings in assessing tolerance and efficacy concerning frailty.
Main Results:
- Many studies inappropriately conclude good tolerability and feasibility in older populations.
- Lack of frailty assessment leads to underestimation of adverse events and overestimation of efficacy in real-world older patients.
Conclusions:
- There is a critical need to improve the reporting of anticancer drug trials in older adults, specifically addressing frailty.
- Enhanced reporting standards will better inform clinicians, patients, and health authorities about the true benefits and risks for this demographic.
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