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Most cancer patients are over 65, yet treatment is chosen by age and guesswork and trials exclude them. Assess fitness properly and design trials that include real older patients.
Geriatric assessment-guided management reduced serious toxicity without compromising survival in randomised trials (GAP70+, GAIN). Uptake remains low and trial populations are far younger and fitter than practice. The proposal is a default assessment (short validated screen with full assessment when triggered) embedded in the record for all patients over 70 starting systemic therapy, payment for the assessment, and a requirement from regulators and funders that pivotal trials include older and comorbid patients in proportion to the treated population, with pre-specified analyses.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated, Trials do not represent the people who get cancer.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated, Trials do not represent the people who get cancer.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Geriatric assessment.
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated, Trials do not represent the people who get cancer.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Older and multimorbid patients are excluded and undertreated.
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.