The age-old problem with cancer

May 22, 2012 | by City of Hope Staff

People over age 65 account for three out of every five cancer cases, and as the media regularly remind us, the Baby Boomer generation is aging into seniors. This Boomer bubble is bringing a medical research problem to light: too few seniors take part in clinical trials of new cancer therapies.

Photo of Arti Hurria Arti Hurria (Photo by p.cunningham)

“There is an overwhelming amount of evidence showing that older adults react differently to cancer drugs,” says Arti Hurria, M.D., director of City of Hope’s Cancer and Aging Research Program. As people grow older, the liver and kidneys don’t work as well, so drugs tend to stay in the body longer.

Because too few seniors are participating in studies of new drugs, though, doctors have less data about how well drugs work — and about their potential side effects — in this age group. And the more data that’s available to physicians, the better their decisions and recommendations for patients.

Kevin Scher, M.D., a second-year hematology fellow at City of Hope, co-wrote a paper with Hurria on this issue for the May issue of the Journal of Clinical Oncology. They’re urging that more seniors be included in clinical trials.

The researchers noted some surprising statistics:

  • Even though 60 percent of people with cancer in the U.S. are 65 or older, they make up only a third of the people in clinical trials.
  • Many studies have so few participants older than 75 that they don’t even report them — even though this age group makes up about 30 percent of cancer patients.

They’re calling for a mandate to include more older adults in drug trials. The strategy has worked before with drugs used by children and adolescents. The Pediatric Research Equity Act of 2003 gave the Food and Drug Administration the authority to mandate pediatric trials for drugs used primarily in this age group. Since the legislation’s passage, information about the effects of medications in pediatric patients has grown significantly.


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