Use of geriatric assessment in cancer clinical trials: A systematic review

Older adults are underrepresented in cancer clinical trials despite accounting for most of the disease burden. Geriatric assessment (GA) could be used in clinical trials of cancer drugs for older adults to improve the clinical evidence for cancer drug use among older adults. To examine patterns of u...

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Bibliographic Details
Published in:Journal of geriatric oncology 2022-09, Vol.13 (7), p.907-913
Main Authors: Lee, Woojung, Cheng, Spencer J., Grant, Shakira J., Marcum, Zachary A., Devine, Beth
Format: Article
Language:English
Subjects:
Aged
Cancer clinical trials
Comorbidity
Geriatric Assessment
Humans
Neoplasms - drug therapy
Older adults
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Summary:Older adults are underrepresented in cancer clinical trials despite accounting for most of the disease burden. Geriatric assessment (GA) could be used in clinical trials of cancer drugs for older adults to improve the clinical evidence for cancer drug use among older adults. To examine patterns of use of GA in cancer clinical trials. We undertook a systematic review of the studies reporting use of GA in a clinical trial setting for all cancer types and published between January 2010 and January 2020. Characteristics of GA use were extracted for each study, along with study phase, cancer type, and participant age (PROSPERO: CRD42020170584). We identified 320 studies and 63 studies met the final inclusion criteria. Among 74 purposes of GA use, the most common was to examine the association between impairments in GA domains and clinical outcomes (28/74, 38%). Among 258 GA domains assessed across 63 studies, physical status (59/258, 23%) and comorbidities (50/258, 19%) were most often evaluated. There was significant heterogeneity in the instruments used to assess physical function (n = 16) and mood disorders (n = 7). Most studies were phase 2 (32/63, 51%). GA is most often used in clinical trial settings to examine associations between GA-identified deficits and clinical outcomes. Significant heterogeneity exists in the GA instruments used across trials. Comprehensive and consistent incorporation of GA into future cancer clinical trial designs could help collect more older adult-specific clinical information and adjust trial eligibility criteria to increase representation by older adults.
ISSN:1879-4068
1879-4076
DOI:10.1016/j.jgo.2022.04.014