Precise treatment of elderly cancer patients has become an increasingly tangled medical problem

At the beginning of the year, the National Academy of Sciences, the Academy of Engineering, and the Academy of Medical Sciences discussed an increasingly tangled medical problem-precision treatment of elderly cancer patients
.

The elderly are a group of patients with special physique

The elderly are a group of patients with special physique

Improve precise treatment decisions for elderly cancer patients:

Improve precise treatment decisions for elderly cancer patients:

For clinical evidence and trial design, we provide seminar expert lecture materials, including clinical diagnosis and treatment methods; how to judge the benefit of patients, improve and guarantee the quality of life and give priority to survival time (hope for recovery)
.

For clinical evidence and trial design, we provide seminar expert lecture materials, including clinical diagnosis and treatment methods; how to judge the benefit of patients, improve and guarantee the quality of life and give priority to survival time (hope for recovery)
.

Are these issues worthy of the industry's attention, active or conservative treatment? How to talk to family members? How to invite elderly patients to participate in clinical trial projects is a problem
.

Are these issues worthy of the industry's attention, active or conservative treatment? How to talk to family members? How to invite elderly patients to participate in clinical trial projects is a problem
.

According to FDA statistics, only 24% of patients participating in clinical trials of oncology drugs are 70 years of age or older, and most clinical trials exclude elderly cancer patients from being included in the group
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However, among common cancer patients, elderly patients 75 years of age or older account for a quarter, and it is still increasing
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In this way, the effect of drug treatment for elderly cancer patients has not been accurately evaluated, and even the best treatment measures have been missed

From a medical point of view, elderly patients are a group of special physiques
.

Test results obtained in young cancer patients may not be directly applicable to elderly patients

Among elderly cancer patients, the rate of comorbid diseases such as cardiopulmonary disease, diabetes, joint muscle disorders, and depression, increases with age
.

U.
S.
federal health insurance data shows that 40% of elderly cancer patients have at least one other chronic disease, coexisting disease or the additive effect of other treatments, which may have a negative impact on cancer treatment and prognosis
.

In 2013, the American Academy of Medical Sciences published a report "Providing High-Quality Cancer Medical Care and Care"
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At that time, it had been found that elderly patients were underrepresented in clinical trials, calling for increased real-world data collection

The American Society of Clinical Oncology (ASCO) has also issued relevant recommendations, but there has been little progress in addressing and addressing this problem in the past ten years
.

In the face of more and more elderly cancer patients, the industry once again called for the need to pay attention to the unequal treatment and unfavorable prejudice of elderly cancer patients

Generally, whether the patient has the opportunity to participate in a clinical trial is recommended or recommended by the doctor
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Compared with young and middle-aged cancer patients, doctors are less willing to recommend that elderly cancer patients participate in the trial.

As a result, clinicians often encounter serious adverse reactions or increased risks when treating elderly patients, and relatively young patients have little benefit from current treatment
.

In addition, clinical trial sponsors may face many unfavorable factors when recruiting elderly patients, such as IRB review and approval
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Due to concerns about the toxic effects (or potential risks) of the trial drugs and complications related to the quality of life of patients, the endpoints of drug trials in elderly patients rarely support the results of drug clinical trials
.

In the field of geriatric oncology, the design of clinical trials, the evaluation of physiological health indicators and the observation of clinical endpoints, etc.
, may have to withdraw midway due to factors such as organ dysfunction and treatment resistance in elderly patients
.

To this end, the third hospital in the United States issued a report again, proposing to expand the availability of clinical data for elderly cancer patients.
The brief introduction is as follows:

To this end, the third hospital in the United States issued a report again, proposing to expand the availability of clinical data for elderly cancer patients.
The brief introduction is as follows:

· Design clinical trials specifically for the elderly; or independent trials or extended cohort trials; fully evaluate the treatment of elderly patients
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· In the trial design, elderly patients were included in the participating groups, and the lowest effective dose and tolerability endpoints were determined, as well as special observation endpoints for elderly patients
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· Conduct preclinical studies to assess the pharmacology and toxicology effects of age on anticancer drugs
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· Explore the appropriate dose in the phase I trial; minimize chronic grade 1 or 2 adverse reactions; reduce the negative impact of the drug on the quality of life and organ function
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· Use new observational endpoints, including composite endpoints, to better define the clinical benefits of the elderly or frail elderly
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· Elements to promote the participation of the elderly in the trial, including eligibility criteria for enrollment, pragmatic trial design, standardized evaluation of the elderly, community health sites, follow-up of participants through telemedicine, etc.

· The data submitted by the FDA needs to show data on drug trials that address the elderly or the frail elderly, and increase the proportion of elderly patients in the trial patients
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· Apply post-marketing clinical diagnosis and treatment results to supplement missing data and information for elderly or frail elderly patients
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· Expand the use of electronic health record data to meet the real-world data collection of the elderly, such as the functional status of the elderly, coexisting diseases, concomitant medications, and patient self-reported results
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· The clinical trial results are required to include a balanced distribution of age distribution and target disease patients
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The choice of treatment for elderly cancer patients is not only a precise treatment issue, but also one of the core issues of social care for the quality of life of the elderly

The choice of treatment for elderly cancer patients is not only a precise treatment issue, but also one of the core issues of social care for the quality of life of the elderly