title: Optimising treatment of elderly patients with ovarian cancer : improving their enrollment in clinical trials.
abstract: The aging population is the fastest growing segment of our population. Over the last century, the average life expectancy has increased by 25 years. The incidence of ovarian carcinoma, seen primarily in postmenopausal women, is, therefore, expected to increase. The current standard treatment of ovarian cancer has been determined on the basis of prospective, randomised clinical trials carried out by cooperative groups. Sixty-one percent of new cancer cases occur in women >65 years of age. Despite this fact, enrollment in clinical trials has been exceedingly low. In turn, this causes suboptimal treatment for a very fatal disease. The aetiology of this is multifactorial, and strategies for improvement are lacking. Elderly patients may be barred from participation based on physician biases alone. Elderly patients may have limited access to academic centres where clinical trials are conducted or be excluded on the basis of unrealistic inclusion criteria. As physicians, it is our duty to understand the elderly patient and the comorbidities in this age group that may influence the tolerability and toxicity of conventional therapies. Therefore, it is imperative that we make a conscious effort to examine ways in which we may improve enrollment of elderly women with ovarian cancer in clinical trials.
authors.affiliation: Department of Surgery, Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA. Jeannine.Villella@RoswellPark.org
authors.forename: Jeannine
authors.initials: J
authors.lastname: Villella
authors.forename: Eva
authors.initials: E
authors.lastname: Chalas
mesh_terms: D000368:Aged; D000375:Aging; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000628:therapy*; D018579:Patient Selection; D012107:Research Design / Q000706:statistics & numerical data; D035842:Research Subjects
references.citation: Obstet Gynecol. 1998 Jul;92(1):94-7
references.pmid: 9649101
references.citation: Drugs Aging. 1992 Mar-Apr;2(2):86-94
references.pmid: 1596598
references.citation: Obstet Gynecol. 2002 May;99(5 Pt 1):704-8
references.pmid: 11978276
references.citation: Oncology (Williston Park). 2001 May;15(5):580-6; discussion 592-4, 597-8
references.pmid: 11396354
references.citation: J Clin Oncol. 2002 Jan 1;20(1):173-8
references.pmid: 11773167
references.citation: Gynecol Oncol. 2002 Sep;86(3):316-22
references.pmid: 12217754
references.citation: Obstet Gynecol. 1996 Sep;88(3):399-402
references.pmid: 8752247
references.citation: Cancer. 2003 May 1;97(9):2150-9
references.pmid: 12712466
references.citation: N Engl J Med. 1999 Dec 30;341(27):2061-7
references.pmid: 10615079
references.citation: Gynecol Oncol. 1990 Apr;37(1):93-5
references.pmid: 2323620
references.citation: J Am Geriatr Soc. 1982 Sep;30(9):568-71
references.pmid: 7108088
references.citation: Gynecol Oncol. 2002 Jun;85(3):445-50
references.pmid: 12051872
references.citation: Drugs Aging. 2003;20(3):229-40
references.pmid: 12578402
references.citation: Cancer. 1993 Jan 15;71(2 Suppl):606-14
references.pmid: 8420683
references.citation: J Clin Oncol. 2003 Apr 1;21(7):1383-9
references.pmid: 12663731
references.citation: Drug Saf. 1990;5 Suppl 1:71-4
references.pmid: 2182066
references.citation: Gynecol Oncol. 2004 Aug;94(2):540-9
references.pmid: 15297201
references.citation: Gynecol Oncol. 2004 Aug;94(2):368-74
references.pmid: 15297174