The geriatric population is under-represented in clinical trials in oncology—especially those for breast cancer. And therefore, clinicians have less research to base their treatment recommendations on. The resources below detail the current research in this area and discuss future areas of study.
- Survey of Oncologists' Perceptions of Barriers to Accrual of Older Patients With Breast Carcinoma to Clinical Trials: This Cancer article details the answers that 150 oncologists gave when researchers asked them about the barriers to accruing older patients into breast cancer trials specifically. Their answers focused on comorbidities, treatment toxicity, and cognition. Because these reasons are so diverse, the article authors suggest several interventions to increase the enrollment of older adults in clinical trials.
- Adjuvant Chemotherapy in Older Women With Early-Stage Breast Cancer: In an effort to increase the pool of data on adjuvant treatment for breast cancer in older adults, the authors of this New England Journal of Medicine article tested capecitabine versus standard therapy in women age 65 and older who had early-stage breast cancer. And they found that for this population, capecitabine is inferior to standard therapy.
- Breast-Conserving Surgery With or Without Irradiation in Women Aged 65 Years or Older With Early Breast Cancer (PRIME II): A Randomised Controlled Trial: Researchers in this Lancet Oncology article sought to uncover the efficacy of radiation therapy in older adults(age 65+) with early stage hormone receptor-positive breast cancer (up to 3cm) who had breast-conserving surgery and were receiving adjuvant endocrine treatment. They found that receipt of whole breast radiation therapy only modestly decreased the 5-year local recurrence rate.
- Management of Elderly Patients With Breast Cancer: Updated Recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA): A taskforce of the International Society of Geriatric Oncology and European Society of Breast Cancer Specialists published these guidelines for the care of geriatric patients with breast cancer. The recommendations—featured in this Lancet Oncology article—take into account patient preferences, treatment barriers, and geriatric assessment, among other factors, and they provide updates on some of the original 2007 recommendations, including treatment of metastatic breast cancer, use of radiotherapy, and benefits and risk of breast cancer screening.
- Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343: This Journal of Clinical Oncology article details findings of a study comparing the benefits of tamoxifen plus adjuvant radiation therapy versus tamoxifen alone in older patients with Stage I hormone receptor-positive breast cancer. Researchers found that receipt of radiation therapy was associated with only a modest decrease in local recurrence and no difference in overall survival among this population of patients age 70 and older.