Background Studies have documented the underrepresentation ofwomen and blacks in clinical trials, and their recruitment isnow federally mandated. However, little is known about the levelof participation of elderly patients. We determined the ratesof enrollment of patients 65 years of age or older in trialsof treatment for cancer.
Methods We analyzed data on 16,396 patients consecutively enrolledin 164 Southwest Oncology Group treatment trials between 1993and 1996 according to sex, race (black or white), and age under65 years or 65 or older. These rates were compared with thecorresponding rates in the general population of patients withcancer, derived from the 1990 U.S. Census and from the NationalCancer Institute's Surveillance, Epidemiology, and End ResultsProgram for the period from 1992 through 1994. Fifteen typesof cancer were included in the analysis.
Results The overall proportions of women and blacks enrolledin Southwest Oncology Group trials were similar to or the sameas the estimated proportions in the U.S. population of patientswith cancer (women, 41 percent and 43 percent; blacks, 10 percentand 10 percent, respectively). In contrast, patients 65 yearsof age or older were underrepresented overall (25 percent vs.63 percent, P<0.001) and in trials involving all 15 typesof cancer except lymphoma. The underrepresentation was particularlynotable in trials of treatment for breast cancer (9 percentvs. 49 percent, P<0.001). The findings were similar whendata on patients who were 70 years of age or older were analyzed,when 15 trials that excluded older patients were eliminatedfrom the analysis, and when community-based enrollment was analyzedseparately from enrollment at academic centers.
Conclusions There is substantial underrepresentation of patients65 years of age or older in studies of treatment for cancer.The reasons should be clarified, and policies adopted to correctthis underrepresentation.
In the late 1980s and early 1990s, federal agencies establishedrequirements that women and members of minority groups be adequatelyrepresented in clinical trials of treatment for cancer.1,2,3,4,5This mandate is crucial in oncology, because with many typesof cancer, biologic, epidemiologic, prognostic, and outcomevariables differ between the sexes, among racial groups, orboth.6,7,8,9,10,11 Moreover, the clinical applicability of theresults of a treatment trial depends in large part on whetherthe sample of patients represents the entire spectrum of patientswho have the type of cancer being studied.
For these reasons, investigators engaged in cooperative trialsof cancer treatment sponsored by the National Cancer Institutehave made concerted efforts to enroll women and members of minoritygroups.12,13,14 In contrast, the enrollment of patients 65 yearsof age or older has received little attention, despite the increasingnumber of older people in the population and the relativelyhigh frequency of cancer, especially solid tumors, in this agegroup.2,15
The Committee on Women and Special Populations of the SouthwestOncology Group (SWOG) analyzed the rates of enrollment of women,blacks, and patients 65 years of age or older, using the SWOGdata base of consecutive cancer-treatment trials. These rateswere compared with the estimated proportions of women, blacks,and persons 65 years of age or older in the U.S. populationof patients with cancer.
Methods
The SWOG Cohort
The SWOG is a national cooperative group, funded by the NationalCancer Institute, that conducts studies of treatment in adultswith cancer. We analyzed data on all consecutive persons enrolledin SWOG treatment trials from 1993 through 1996. Enrollmentdata were examined for trials involving all major cancers (invasivedisease only): cancer of the bladder, brain, breast, cervix,colon and rectum, head and neck, lung, ovary, pancreas, andprostate; lymphoma; melanoma; myeloma; leukemia; and soft-tissuesarcoma. For each type of cancer, the percentages of enrolledwomen, blacks, and patients 65 years of age or older were comparedwith the corresponding percentages in the U.S. population ofpatients with cancer. The number of trials restricted to premenopausalpatients or to patients 65 years of age or younger or 70 yearsof age or younger was ascertained.
U.S. Population of Patients with Cancer
The numbers of patients with cancer in the U.S. population wereestimated on the basis of 1990 U.S. Census data and data fromthe National Cancer Institute's Surveillance, Epidemiology,and End Results (SEER) Program for the period from 1992 through1994. Both sets of data represented the most recent informationavailable at the time of the analysis. The nine SEER registryareas represented 9.5 percent of the U.S. population. Patientswith in situ cancers were excluded.
A subgroup of interest was defined by each unique combinationof age (in five-year intervals), sex, and designation as whiteor black. Three computations were performed for each type ofcancer. First, the number of new cases of cancer in each subgroupof interest in the SEER area was divided by the population inthat area for that subgroup (on the basis of the 1990 U.S. Census);the result of this calculation was the SEER incidence rate foreach subgroup of interest. Second, the SEER incidence rate wasmultiplied by the total U.S. population for each subgroup ofinterest, yielding the estimated number of new cases of cancernationally for that subgroup. Third, the national number ofnew cases of cancer for each subgroup of interest was dividedby the total number of new cases of cancer; the result of thiscalculation was the estimated percentage corresponding to thesubgroup (women, blacks, or patients 65 years of age or older)in the United States for each type of cancer.
Comparison of SWOG and National Rates
For analyses according to sex, enrollments of patients withcancers other than cancers of the breast, cervix, ovary, andprostate were included. Patients enrolled at military or Departmentof Veterans Affairs centers were compared with patients enrolledat all other centers to determine differences in the rates ofenrollment of women. The military or Department of VeteransAffairs affiliation of each patient was determined on the basisof the method of payment for health care, information that since1993 has been required at the time of enrollment. Therefore,the SWOG enrollment period from 1993 through 1996 was chosenas the period closest to the most recent SEER data (1992 through1994).
The proportions of women, blacks, and patients 65 years of ageor older in the SWOG data base and in the U.S. population ofpatients with cancer were compared for each type of cancer.The subgroup of blacks was chosen as the largest potentiallyunderserved population. The age of 65 years was chosen as thecutoff point for the primary analysis because it is the ageat which people become eligible for Medicare. Enrollment ofpatients 70 years of age or older was also analyzed.
SWOG enrollment rates according to age were analyzed accordingto whether enrollment was conducted at large, urban academiccenters or community-based practices. The latter included bothCommunity Clinical Oncology Programs (community services designatedand funded by the National Cancer Institute) and CooperativeGroup Outreach Programs (community-based networks of physiciansaffiliated with member institutions). To determine whether community-basedpractices were more or less likely than urban academic centersto enroll patients 65 years of age or older, rates of enrollmentof older patients in community-based practices were comparedwith the corresponding rates for their urban academic counterparts.
Statistical Analysis
The rates of cancer in the U.S. population were considered tobe fixed in the comparisons with SWOG enrollment rates. One-samplebinomial tests were used to compare the rates. To adjust formultiple comparisons, only two-tailed P values of 0.01 or less(rather than the standard 0.05) were considered to indicatestatistical significance.
Results
Table 1 shows the numbers of patients enrolled in SWOG treatmenttrials during the period from 1993 through 1996, according tothe type of cancer. Overall, 16,396 patients were enrolled in164 studies. Forty-one percent of the patients who did not havesex-specific cancers and who were enrolled at sites withoutmilitary or Department of Veterans Affairs affiliations werewomen, 10 percent of all patients were black, and 25 percentof all patients were 65 years of age or older.
Table 1. Enrollment of Women, Blacks, and Elderly Patients in Southwest Oncology Group Treatment Trials from 1993 through 1996, According to the Type or Site of Cancer.
Enrollment of Women
A total of 9671 patients were enrolled in trials that did notinvolve sex-specific cancers, such as breast and prostate cancer.For every type of cancer, the proportion of women at militaryor Department of Veterans Affairs centers was substantiallysmaller than the proportion of women at other centers, as wouldbe expected on the basis of the demographic characteristicsof patients at military or Department of Veterans Affairs medicalfacilities (data not shown). Thus, 838 patients who were enrolledat these centers were excluded from all analyses according tosex (since they constituted a unique cohort with respect tothe enrollment of women), for a total of 8833 patients.
The overall enrollment rate for women in the SWOG trials (41percent) was similar to the proportion of women in the U.S.population of patients with cancer (43 percent). Figure 1 showsthe proportions of women enrolled in SWOG trials and the proportionsof women in the U.S. population of patients with cancer for11 types of cancer. Differences between the two groups weresignificant only for colorectal cancer (P<0.001), head andneck cancer (P= 0.007), and lymphoma (P<0.001), with a differenceof only 7 percentage points for each type.
Figure 1. Proportion of Women Enrolled in Trials of the Southwest Oncology Group (SWOG) as Compared with the Proportion of Women in the U.S. Population of Patients with Cancer, According to the Type of Cancer.
All patients with sex-specific cancers and all patients enrolled at centers with military or Department of Veterans Affairs affiliations were excluded from the analysis according to sex.
Enrollment of Blacks
All types of cancer and all types of treatment facilities wereincluded in analyses of the enrollment of black patients. Theyrepresented 10 percent of the patients enrolled in SWOG trials,which is the same as the proportion of blacks in the U.S. populationof patients with cancer. Figure 2 compares the enrollment ofblack patients in SWOG trials with the proportion of blacksin the U.S. population of patients with cancer for 15 typesof cancer. Blacks were significantly underenrolled only in trialsof treatment for lymphoma (P<0.001) and ovarian cancer (P=0.002),a difference of only 4 percentage points for each type. Conversely,black patients were significantly overrepresented in SWOG trialsof treatment for head and neck cancer (P<0.001), leukemia(P=0.001), and prostate cancer (P<0.001).
Figure 2. Proportion of Blacks Enrolled in Trials of the Southwest Oncology Group (SWOG) as Compared with the Proportion of Blacks in the U.S. Population of Patients with Cancer, According to the Type of Cancer.
Enrollment of Older Patients
All types of cancer and all types of treatment facilities wereincluded in the analyses according to age. Overall, patientswho were 65 years of age or older accounted for 25 percent ofpatients in SWOG trials, as compared with 63 percent in theU.S. population of patients with cancer (P<0.001). When theage cutoff was set at 70 years, the proportions of patientsenrolled in SWOG trials and those in the U.S. population ofpatients with cancer were 13 percent and 47 percent, respectively(P<0.001). Thus, the proportions of patients who were 65to 69 years old were 12 percent in the SWOG trials and 16 percentin the U.S. population of patients with cancer (P<0.001).These figures indicate that patients who were 70 years of ageor older accounted for much of the shortfall in enrollment butnot all of it.
The percentage of patients 65 years of age or older who wereenrolled in the SWOG trials was significantly less than thepercentage of such patients in the U.S. population of patientswith cancer (P<0.001) for all types of cancer except lymphoma(Figure 3). The difference persisted when the analysis was restrictedto the 2127 patients who were 70 years of age or older (datanot shown) and was unrelated to the type of oncologic practice(patients in community-based practices, 27 percent; patientsat urban academic centers, 22 percent).
Figure 3. Proportion of Elderly Patients (65 Years of Age or Older) in Trials of the Southwest Oncology Group (SWOG) as Compared with the Proportion of Elderly Patients in the U.S. Population of Patients with Cancer, According to the Type of Cancer.
The differences between the two groups were significant (P<0.001) for all types of cancer except lymphoma.
Thirteen studies conducted by SWOG (involving 819 patients,or 5 percent of the total number) were restricted to patientswho were 65 years old or younger or to women who were premenopausal,and 15 trials (involving 1043 patients, or 6 percent) were restrictedto patients who were 70 years old or younger or to women whowere premenopausal. With these studies excluded, the overallrate of enrollment of patients 65 years old or older was 27percent (as compared with 25 percent for all the studies), andfor patients who were 70 years old or older, the overall enrollmentrate was 14 percent (as compared with 13 percent for all thestudies). The SWOG enrollment rate for elderly patients withbreast cancer changed from 9 percent to 10 percent when the293 patients enrolled in trials restricted to premenopausalpatients or to patients 65 years old or younger were excluded.
Discussion
We found that the enrollment rates for women and blacks in SWOGtrials of cancer treatment were similar to the proportions ofwomen and blacks in the U.S. population of patients with cancer.In contrast, the enrollment rate for patients 65 years of ageor older was unexpectedly low. Underenrollment of elderly patientswas particularly striking in trials of treatment for breastcancer, even after the exclusion of trials restricted to premenopausalwomen or to patients who were 65 years old or younger. In theU.S. population of patients with cancer, 49 percent of breastcancers occurred in patients who were 65 years old or older,whereas only 9 percent of patients enrolled in SWOG-sponsoredstudies of breast cancer were 65 or older.
Some studies have found age-related differences in the pharmacologiccharacteristics and toxicity of chemotherapeutic drugs in patientswith breast cancer, whereas others have not.16,17,18,19 Theresults of two retrospective analyses of clinical trials involvingpatients with solid tumors suggest that older age does not diminishtolerance of or response to chemotherapy.20,21 These findingsraise questions that can be answered definitively only by theprospective enrollment of larger numbers of elderly patientsin clinical trials.
A representative sample of adults of all ages is necessary inphase 2 studies that assess the toxicity and pharmacologic propertiesof chemotherapeutic drugs. This policy has been inconsistentlyimplemented in trials of new agents approved for the treatmentof common solid tumors. Adequate enrollment of older patientsis also required in phase 3 trials, especially because of thepotential interactions between age and toxicity and becauseage is often an independent prognostic variable.
Why are the rates of enrollment of elderly patients in trialsof treatment for cancer disproportionately low? The reasonsinclude misconceptions about the benefits of enrollment in clinicaltrials for older patients on the part of the patients themselves,their family members, or their physicians; stringent eligibilitycriteria; coexisting medical conditions; and logistic barriers.14,15,22
Clinicians and patients and their families may assume that olderpatients with cancer are not likely to tolerate or benefit fromtreatment in clinical trials. They may consider these studiestoo "experimental" or the treatments too toxic or otherwiseinappropriate for older patients.22,23 In a survey of Americanoncologists, 80 percent of the respondents agreed with publisheddata showing that patients have better outcomes when they receivetreatment in clinical trials, but 50 percent indicated thatthey declare patients unsuitable for clinical trials on thebasis of age alone.22
There are few data supporting the notion that fit older patientscannot tolerate or benefit from treatment in clinical trials,especially studies that test standard drugs for common solidtumors. Most clinical trials do not enroll enough older patientsto permit an analysis of treatment and outcome end points inthis age group. However, the first cooperative group studiesdesigned specifically for older patients have recently beencompleted.24,25 Other, ongoing trials are analyzing toxicity,pharmacologic factors, and outcomes in subgroups of older patients.
Data from studies of leukemia in older patients highlight theimportance of designing studies specifically for elderly patientswith cancer. Older patients with leukemia do not tolerate intensivetreatment well and have poor outcomes,26,27,28 often becauseof coexisting medical conditions and age-related end-organ orimmune dysfunction. Recent studies show that the poor outcomein older patients with leukemia is also related to specificbiologic characteristics: a high frequency of unfavorable cytogeneticfactors, increased expression of the MDR1 protein, and functionalefflux of chemotherapeutic drugs from the leukemic cells.29Cooperative groups are now conducting trials designed to modulatethese biologic abnormalities in older patients with leukemia.Similar studies are needed to determine whether there are age-relatedbiologic characteristics of common solid tumors.
Stringent eligibility criteria that prevent the enrollment ofmany patients in clinical trials are important safeguards againstexcessive treatment-related morbidity and mortality. Older patientsoften do not meet the eligibility criteria because of organimpairment or coexisting medical conditions. These conditionsmay increase the risk of excessive treatment-related toxicity,thus influencing the results of the trial.30 Because of thesestringent restrictions, little is known about whether olderpatients with normal age-related organ impairment or those withcoexisting diseases that may not interact with the treatmentunder study can tolerate the treatment and benefit from it.31
The accessibility of medical care is particularly importantin the case of older patients with cancer. Since transportationcosts are not covered by Medicare, traveling to the study sitemay be an insurmountable barrier. Such logistical factors mayalso influence physicians' decisions about recommending participationin clinical trials.19 Financial barriers to participation intrials of cancer treatment may be greater for older patientsthan for younger patients. Medicare does not provide reimbursementfor most of the outpatient prescription drugs needed to controlthe side effects of chemotherapy. Clinical trials are oftenconsidered experimental by Medicare, and billing for investigationaltreatments is not permitted. However, these financial barriersare not the only explanation for the underrepresentation ofolder patients. The National Cancer Institute of Canada ClinicalTrials Group reported a markedly decreased rate of enrollmentof older patients in Canadian trials of cancer treatment, eventhough the Canadian national health program provides reimbursementfor all health care costs, including those associated with participationin a clinical trial.32
Our retrospective analysis is limited in providing reasons forthe low rate of enrollment of older patients. The SWOG database does not contain data for all patients referred to eachinstitution; it contains data only for enrolled patients. Forthis reason, the low rate of enrollment of patients 65 yearsof age or older may be due to a low rate of enrollment of olderpatients at each center or to a low rate of referral of olderpatients to the center. Our analysis can eliminate two explanations:study-imposed age restrictions (because overall rates increasedonly slightly when trials with upper-age restrictions were excludedfrom the analysis) and the type of center (since older patientswere underrepresented at both urban academic centers and community-basedpractices).
Our findings have implications for federal policies concerningclinical trials. By 2030, the number of persons in the UnitedStates over the age of 65 years will have doubled, and the numberof persons over the age of 85 years will have quadrupled. Becauseof the relatively high risk of cancer in these populations,we predict a high prevalence of cases of cancer in older membersof the U.S. population in the future. It may not be prematureto implement prospective trials in order to determine why therates of enrollment of elderly patients in cancer trials arelow, to study and modulate the biologic features of cancer inolder patients, and to design therapy for otherwise fit olderpatients with cancer.
Supported in part by grants from the National Cancer Institute(CA32102, CA38926, CA37981, CA22433, and CA46282).
We are indebted to the investigators of the Southwest OncologyGroup and to all their patients who are represented in our analysis,and specifically to the chairpersons of the disease committeesfrom 1993 to the present — D. Alberts, K. Antman, F. Appelbaum,S. Balcerzak, B. Barlogie, E.D. Crawford, J. Ensley, R. Fisher,D. Gandara, R. Livingston, J. Macdonald, S. Martino, T. Miller,S. Salmon, S.C. Schold, Jr., D. Schuller, V. Sondak, K.J. Stelzer,and C. Willman; to O. Brawley, P. Ganz, D. Giroux, J. Godwin,C. Gotay, P. Ravdin, E. Trimble, and R. Yancik for their valuableassistance during the conduct of the trial; and to the membersof the Committee on Women and Special Populations of the SouthwestOncology Group.
Source Information
From the Department of Medicine, Division of Hematology and Oncology, University of Arkansas for Medical Sciences, Little Rock (L.F.H.); the Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle (J.M.U., J.J.C.); the Department of Medical Oncology, University of Texas Health Science Center at San Antonio, San Antonio (C.A.C.); and the Department of Medicine, Division of Hematology and Oncology, Loyola University Medical Center, Maywood, Ill. (K.S.A.).
Address reprint requests to the Southwest Oncology Group, Operations Office, 4980 Omicron Dr., San Antonio, TX 78245-3217, or to bgranados{at}swog.org.
References
Schmucker DL, Vesell ES. Underrepresentation of women in clinical drug trials. Clin Pharmacol Ther 1993;54:11-15. [Medline]
Pinn VW. Women, research, and the National Institutes of Health. Am J Prev Med 1992;8:324-327. [Erratum, J Prev Med 1992;8:399.] [Medline]
Food and Drug Administration. Guideline for the study and evaluation of gender differences in the clinical evaluation of drugs: notice. Fed Regist 1993;58:39406-39416. [Medline]
Merkatz RB, Temple R, Sobel S, Feiden K, Kessler DA, Working Group on Women in Clinical Trials. Women in clinical trials of new drugs: a change in Food and Drug Administration policy. N Engl J Med 1993;329:292-296. [Free Full Text]
Cotton P. FDA lifts ban on women in early drug tests, will require companies to look for gender differences. JAMA 1993;269:2067-2067. [Free Full Text]
Gotay CC, Phillips PH, Cheson BD. Male-female differences in the impact of cancer therapy. Oncology (Huntingt) 1993;7:67-74.
Dignam JJ, Redmond CK, Fisher B, Costantino JP, Edwards BK. Prognosis among African-American women and white women with lymph node negative breast carcinoma: findings from two randomized clinical trials of the National Surgical Adjuvant Breast and Bowel Project (NSABP). Cancer 1997;80:80-90. [CrossRef][Medline]
Baquet C, Ringen K. Cancer control in blacks: epidemiology and NCI program plans. Prog Clin Biol Res 1986;216:215-227. [Medline]
Makuc DM, Fried VM, Kleinman JC. National trends in the use of preventive health care of women. Am J Public Health 1989;79:21-26. [Free Full Text]
Freeman HP, Wasfie TJ. Cancer of the breast in poor black women. Cancer 1989;63:2562-2569. [CrossRef][Medline]
ACS sets blueprint for action against prostate cancer in African Americans. JAMA 1998;279:418-419. [Free Full Text]
Chamberlain RM, Winter KA, Vijayakumar S, et al. Sociodemographic analysis of patients in Radiation Therapy Oncology Group clinical trials. Int J Radiat Oncol Biol Phys 1998;40:9-15. [CrossRef][Medline]
Tejeda HA, Green SB, Trimble EL, et al. Representation of African-Americans, Hispanics, and whites in National Cancer Institute cancer treatment trials. J Natl Cancer Inst 1996;88:812-816.
Hayunga EG, Costello MD, Pinn VW. Demographics of study populations. Appl Clin Trials 1997;6:41-5.
Trimble EL, Carter CL, Cain D, Freidlin B, Ungerleider RS, Friedman MA. Representation of older patients in cancer treatment trials. Cancer 1994;74:Suppl:2208-2214. [CrossRef][Medline]
Dees EC, O'Reilly S, Goodman S, et al. A prospective pharmacologic evaluation of age-related toxicity of adjuvant chemotherapy in women with breast cancer. Proc Am Soc Clin Oncol 1998;17:103a. abstract.
Crivellari D, Bonetti M, Castiglione M. Adjuvant treatment of elderly patients with node-positive breast cancer: CMF tolerability in International Breast Cancer Study Group Trial VII. Proc Am Soc Clin Oncol 1998;17:102a. abstract.
Bonadonna G. Evolving concepts in the systemic adjuvant treatment of breast cancer. Cancer Res 1992;52:2127-2137. [Free Full Text]
Christman K, Muss HB, Case LD, Stanley V. Chemotherapy of metastatic breast cancer in the elderly: the Piedmont Oncology Association experience. JAMA 1992;268:57-62. [Free Full Text]
Begg CB, Cohen JL, Ellerton J. Are the elderly predisposed to toxicity from cancer chemotherapy? An investigation using data from the Eastern Cooperative Oncology Group. Cancer Clin Trials 1980;3:369-374. [Medline]
Giovanazzi-Bannon S, Rademaker A, Lai G, Benson AB III. Treatment tolerance of elderly cancer patients entered onto phase II clinical trials: an Illinois Cancer Center study. J Clin Oncol 1994;12:2447-2452. [Free Full Text]
Benson AB III, Pregler JP, Bean JA, Rademaker AW, Eshler B, Anderson K. Oncologists' reluctance to accrue patients onto clinical trials: an Illinois Cancer Center study. J Clin Oncol 1991;9:2067-2075. [Free Full Text]
Yancik R, Ries LG, Yates JW. Ovarian cancer in the elderly: an analysis of Surveillance, Epidemiology, and End Results Program data. Am J Obstet Gynecol 1986;154:639-647. [Medline]
The Elderly Lung Cancer Vinorelbine Italian Study Group. Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. J Natl Cancer Inst 1999;91:66-72. [Free Full Text]
Godwin JE, Kopecky KJ, Head DR, et al. A double-blind placebo-controlled trial of granulocyte colony-stimulating factor in elderly patients with previously untreated acute myeloid leukemia: a Southwest Oncology Group study (9031). Blood 1998;91:3607-3615. [Free Full Text]
Feldman EJ. Acute myelogenous leukemia in the older patient. Semin Oncol 1995;22:Suppl 1:21-24. [Medline]
Johnson PRE, Liu Yin JA. Acute myeloid leukaemia in the elderly: biology and treatment. Br J Haematol 1993;83:1-6. [Medline]
Ryan DH, Kopecky KJ, Head D, et al. Analysis of treatment failure in acute nonlymphocytic leukemia patients over fifty years of age: a Southwest Oncology Group study. Am J Clin Oncol 1992;15:69-75. [Medline]
Leith CP, Kopecky KJ, Godwin J, et al. Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy: a Southwest Oncology Group study. Blood 1997;89:3323-3329. [Free Full Text]
Angell M. Caring for women's health -- what is the problem? N Engl J Med 1993;329:271-272. [Free Full Text]
Hutchins LF, Lipschitz DA. Cancer, clinical pharmacology, and aging. Clin Geriatr Med 1987;3:483-503. [Medline]
Marlin SM, Pater JL, Myles JD. Characteristics of National Cancer Institute of Canada Clinical Trials Group participants (1974-1993). Clin Invest Med 1996;19:Suppl:50a-50a.abstract
De Santis, M., Bellmunt, J., Mead, G., Kerst, J. M., Leahy, M., Maroto, P., Skoneczna, I., Marreaud, S., de Wit, R., Sylvester, R.
(2009). Randomized Phase II/III Trial Assessing Gemcitabine/ Carboplatin and Methotrexate/Carboplatin/Vinblastine in Patients With Advanced Urothelial Cancer "Unfit" for Cisplatin-Based Chemotherapy: Phase II--Results of EORTC Study 30986. JCO
27: 5634-5639
[Abstract][Full Text]
Anderson, W. F., Jatoi, I., Sherman, M. E.
(2009). Qualitative Age Interactions in Breast Cancer Studies: Mind the Gap. JCO
27: 5308-5311
[Full Text]
Lai, R., Hershman, D. L., Doan, T., Neugut, A. I.
(2009). The timing of cranial radiation in elderly patients with newly diagnosed glioblastoma multiforme. Neuro Oncology
0: nop004v1-nop004
[Abstract][Full Text]
Pallis, A. G., Gridelli, C., van Meerbeeck, J. P., Greillier, L., Wedding, U., Lacombe, D., Welch, J., Belani, C. P., Aapro, M.
(2009). EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts' opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Oncol
0: mdp360v1-mdp360
[Abstract][Full Text]
Albain, K. S., Unger, J. M., Crowley, J. J., Coltman, C. A. Jr, Hershman, D. L.
(2009). Racial Disparities in Cancer Survival Among Randomized Clinical Trials Patients of the Southwest Oncology Group. JNCI J Natl Cancer Inst
101: 984-992
[Abstract][Full Text]
Smith, B. D., Smith, G. L., Hurria, A., Hortobagyi, G. N., Buchholz, T. A.
(2009). Future of Cancer Incidence in the United States: Burdens Upon an Aging, Changing Nation. JCO
27: 2758-2765
[Abstract][Full Text]
Anderson, W. F.
(2009). Cancer Surveillance Research. Cancer Epidemiol. Biomarkers Prev.
18: 1669-1671
[Full Text]
Muss, H. B., Berry, D. A., Cirrincione, C. T., Theodoulou, M., Mauer, A. M., Kornblith, A. B., Partridge, A. H., Dressler, L. G., Cohen, H. J., Becker, H. P., Kartcheske, P. A., Wheeler, J. D., Perez, E. A., Wolff, A. C., Gralow, J. R., Burstein, H. J., Mahmood, A. A., Magrinat, G., Parker, B. A., Hart, R. D., Grenier, D., Norton, L., Hudis, C. A., Winer, E. P., the CALGB Investigators,
(2009). Adjuvant Chemotherapy in Older Women with Early-Stage Breast Cancer. NEJM
360: 2055-2065
[Abstract][Full Text]
Porta, M. G. D., Malcovati, L.
(2009). Clinical relevance of extra-hematologic comorbidity in the management of patients with myelodysplastic syndrome. haematol
94: 602-606
[Full Text]
Rowe, J. M.
(2009). Closer to the truth in AML. Blood
113: 4129-4130
[Full Text]
Derolf, A. R., Kristinsson, S. Y., Andersson, T. M.-L., Landgren, O., Dickman, P. W., Bjorkholm, M.
(2009). Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005. Blood
113: 3666-3672
[Abstract][Full Text]
Stinchcombe, T. E., Socinski, M. A.
(2009). Current Treatments for Advanced Stage Non-Small Cell Lung Cancer. Proc Am Thorac Soc
6: 233-241
[Abstract][Full Text]
Nghiemphu, P. L., Liu, W., Lee, Y., Than, T., Graham, C., Lai, A., Green, R. M., Pope, W. B., Liau, L. M., Mischel, P. S., Nelson, S. F., Elashoff, R., Cloughesy, T. F.
(2009). Bevacizumab and chemotherapy for recurrent glioblastoma: A single-institution experience. Neurology
72: 1217-1222
[Abstract][Full Text]
Ramalingam, S. S., Khuri, F. R.
(2009). The Role of the Taxanes in the Treatment of Older Patients with Advanced Stage Non-Small Cell Lung Cancer. The Oncologist
14: 412-424
[Abstract][Full Text]
Kabbinavar, F. F., Hurwitz, H. I., Yi, J., Sarkar, S., Rosen, O.
(2009). Addition of Bevacizumab to Fluorouracil-Based First-Line Treatment of Metastatic Colorectal Cancer: Pooled Analysis of Cohorts of Older Patients From Two Randomized Clinical Trials. JCO
27: 199-205
[Abstract][Full Text]
Seol, Y. M., Song, M. K., Choi, Y. J., Kim, G. H., Shin, H. J., Song, G. A., Chung, J. S., Cho, G. J.
(2009). Oral Fluoropyrimidines (Capecitabine or S-1) and Cisplatin as First Line Treatment in Elderly Patients with Advanced Gastric Cancer: A Retrospective Study. Jpn J Clin Oncol
39: 43-48
[Abstract][Full Text]
Papamichael, D., Audisio, R., Horiot, J.-C., Glimelius, B., Sastre, J., Mitry, E., Van Cutsem, E., Gosney, M., Kohne, C.-H., Aapro, M.
(2009). Treatment of the elderly colorectal cancer patient: SIOG expert recommendations. Ann Oncol
20: 5-16
[Abstract][Full Text]
Tu, J. V., Ko, D. T.
(2008). Ecological Studies and Cardiovascular Outcomes Research. Circulation
118: 2588-2593
[Full Text]
Eisen, T., Oudard, S., Szczylik, C., Gravis, G., Heinzer, H., Middleton, R., Cihon, F., Anderson, S., Shah, S., Bukowski, R., Escudier, B., for the TARGET Study Group,
(2008). Sorafenib for Older Patients With Renal Cell Carcinoma: Subset Analysis From a Randomized Trial. JNCI J Natl Cancer Inst
100: 1454-1463
[Abstract][Full Text]
von Plessen, C, Strand, T-E, Wentzel-Larsen, T, Omenaas, E, Wilking, N, Sundstrom, S, Sorenson, S
(2008). Effectiveness of third-generation chemotherapy on the survival of patients with advanced non-small cell lung cancer in Norway: a national study. Thorax
63: 866-871
[Abstract][Full Text]
McKibbin, T., Frei, C. R., Greene, R. E., Kwan, P., Simon, J., Koeller, J. M.
(2008). Disparities in the Use of Chemotherapy and Monoclonal Antibody Therapy for Elderly Advanced Colorectal Cancer Patients in the Community Oncology Setting. The Oncologist
13: 876-885
[Abstract][Full Text]
Fruh, M., Rolland, E., Pignon, J.-P., Seymour, L., Ding, K., Tribodet, H., Winton, T., Le Chevalier, T., Scagliotti, G. V., Douillard, J. Y., Spiro, S., Shepherd, F. A.
(2008). Pooled Analysis of the Effect of Age on Adjuvant Cisplatin-Based Chemotherapy for Completely Resected Non-Small-Cell Lung Cancer. JCO
26: 3573-3581
[Abstract][Full Text]
Baquet, C. R., Ellison, G. L., Mishra, S. I.
(2008). Analysis of Maryland Cancer Patient Participation in National Cancer Institute-Supported Cancer Treatment Clinical Trials. JCO
26: 3380-3386
[Abstract][Full Text]
Basche, M., Baron, A. E., Eckhardt, S. G., Balducci, L., Persky, M., Levin, A., Jackson, N., Zeng, C., Vranas, P., Steiner, J. F.
(2008). Barriers to Enrollment of Elderly Adults in Early-Phase Cancer Clinical Trials. J Oncol Pract
4: 162-168
[Abstract][Full Text]
Hurria, A., Balducci, L., Naeim, A., Gross, C., Mohile, S., Klepin, H., Tew, W., Downey, L., Gajra, A., Owusu, C., Sanati, H., Suh, T., Figlin, R.
(2008). Mentoring Junior Faculty in Geriatric Oncology: Report From the Cancer and Aging Research Group. JCO
26: 3125-3127
[Full Text]
Internullo, E., Moons, J., Nafteux, P., Coosemans, W., Decker, G., De Leyn, P., Van Raemdonck, D., Lerut, T.
(2008). Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Eur. J. Cardiothorac. Surg.
33: 1096-1104
[Abstract][Full Text]
Wheatley-Price, P., Ding, K., Seymour, L., Clark, G. M., Shepherd, F. A.
(2008). Erlotinib for Advanced Non-Small-Cell Lung Cancer in the Elderly: An Analysis of the National Cancer Institute of Canada Clinical Trials Group Study BR.21. JCO
26: 2350-2357
[Abstract][Full Text]
Field, K. M., Kosmider, S., Jefford, M., Michael, M., Jennens, R., Green, M., Gibbs, P.
(2008). Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey. J Oncol Pract
4: 108-113
[Abstract][Full Text]
Rogers, W. A., Ballantyne, A. J., Australian Gender Equity in Health Research Group,
(2008). Exclusion of Women From Clinical Research: Myth or Reality?. Mayo Clin Proc.
83: 536-542
[Abstract][Full Text]
Levi, M., Hovingh, G. K., Cannegieter, S. C., Vermeulen, M., Buller, H. R., Rosendaal, F. R.
(2008). Bleeding in patients receiving vitamin K antagonists who would have been excluded from trials on which the indication for anticoagulation was based. Blood
111: 4471-4476
[Abstract][Full Text]
Meinert, C. L
(2008). Long-term drug prevention trials. Clin Trials
5: 168-176
[Abstract]
Dhruva, S. S., Redberg, R. F.
(2008). Variations Between Clinical Trial Participants and Medicare Beneficiaries in Evidence Used for Medicare National Coverage Decisions. Arch Intern Med
168: 136-140
[Abstract][Full Text]
Asmis, T. R., Ding, K., Seymour, L., Shepherd, F. A., Leighl, N. B., Winton, T. L., Whitehead, M., Spaans, J. N., Graham, B. C., Goss, G. D.
(2008). Age and Comorbidity As Independent Prognostic Factors in the Treatment of Non-Small-Cell Lung Cancer: A Review of National Cancer Institute of Canada Clinical Trials Group Trials. JCO
26: 54-59
[Abstract][Full Text]
Lichtman, S. M.
(2008). Pharmacology of Antineoplastic Agents for Older Patients. Am Soc Clin Oncol Ed Book
2008: 210-214
[Abstract][Full Text]
Lipscombe, L. L., Gomes, T., Levesque, L. E., Hux, J. E., Juurlink, D. N., Alter, D. A.
(2007). Thiazolidinediones and Cardiovascular Outcomes in Older Patients With Diabetes. JAMA
298: 2634-2643
[Abstract][Full Text]
Owonikoko, T. K., Ragin, C. C., Belani, C. P., Oton, A. B., Gooding, W. E., Taioli, E., Ramalingam, S. S.
(2007). Lung Cancer in Elderly Patients: An Analysis of the Surveillance, Epidemiology, and End Results Database. JCO
25: 5570-5577
[Abstract][Full Text]
Hurria, A.
(2007). Incorporation of Geriatric Principles in Oncology Clinical Trials. JCO
25: 5350-5351
[Full Text]
Golberstein, E., Liang, J., Quinones, A., Wolinsky, F. D.
(2007). Does More Health Care Improve Health Among Older Adults? A Longitudinal Analysis. J Aging Health
19: 888-906
[Abstract]
Balducci, L., Al-Halawani, H., Charu, V., Tam, J., Shahin, S., Dreiling, L., Ershler, W. B.
(2007). Elderly Cancer Patients Receiving Chemotherapy Benefit from First-Cycle Pegfilgrastim. The Oncologist
12: 1416-1424
[Abstract][Full Text]
Elkin, E. B., Kim, S. H.M., Casper, E. S., Kissane, D. W., Schrag, D.
(2007). Desire for Information and Involvement in Treatment Decisions: Elderly Cancer Patients' Preferences and Their Physicians' Perceptions. JCO
25: 5275-5280
[Abstract][Full Text]
Pinder, M. C., Duan, Z., Goodwin, J. S., Hortobagyi, G. N., Giordano, S. H.
(2007). Congestive Heart Failure in Older Women Treated With Adjuvant Anthracycline Chemotherapy for Breast Cancer. JCO
25: 3808-3815
[Abstract][Full Text]
Muss, H. B., Berry, D. A., Cirrincione, C., Budman, D. R., Henderson, I. C., Citron, M. L., Norton, L., Winer, E. P., Hudis, C. A.
(2007). Toxicity of Older and Younger Patients Treated With Adjuvant Chemotherapy for Node-Positive Breast Cancer: The Cancer and Leukemia Group B Experience. JCO
25: 3699-3704
[Abstract][Full Text]
Dellapasqua, S., Colleoni, M., Castiglione, M., Goldhirsch, A.
(2007). New Criteria for Selecting Elderly Patients for Breast Cancer Adjuvant Treatment Studies. The Oncologist
12: 952-959
[Abstract][Full Text]
Wagner, A. D., Wedding, U., Kuss, O., Hoffken, K.
(2007). Docetaxel for Advanced Gastric Cancer?. JCO
25: 2490-2491
[Full Text]
Ding, E. L., Powe, N. R., Manson, J. E., Sherber, N. S., Braunstein, J. B.
(2007). Sex Differences in Perceived Risks, Distrust, and Willingness to Participate in Clinical Trials: A Randomized Study of Cardiovascular Prevention Trials. Arch Intern Med
167: 905-912
[Abstract][Full Text]
Lichtman, S. M., Balducci, L., Aapro, M.
(2007). Geriatric Oncology: A Field Coming of Age. JCO
25: 1821-1823
[Full Text]
Lichtman, S. M., Wildiers, H., Chatelut, E., Steer, C., Budman, D., Morrison, V. A., Tranchand, B., Shapira, I., Aapro, M.
(2007). International Society of Geriatric Oncology Chemotherapy Taskforce: Evaluation of Chemotherapy in Older Patients--An Analysis of the Medical Literature. JCO
25: 1832-1843
[Abstract][Full Text]
Muss, H. B., Biganzoli, L., Sargent, D. J., Aapro, M.
(2007). Adjuvant Therapy in the Elderly: Making the Right Decision. JCO
25: 1870-1875
[Abstract][Full Text]
Gridelli, C., Langer, C., Maione, P., Rossi, A., Schild, S. E.
(2007). Lung Cancer in the Elderly. JCO
25: 1898-1907
[Abstract][Full Text]
Estey, E.
(2007). Acute Myeloid Leukemia and Myelodysplastic Syndromes in Older Patients. JCO
25: 1908-1915
[Abstract][Full Text]
Rodin, M. B., Mohile, S. G.
(2007). A Practical Approach to Geriatric Assessment in Oncology. JCO
25: 1936-1944
[Abstract][Full Text]
Wolpin, B. M., Meyerhardt, J. A., Mamon, H. J., Mayer, R. J.
(2007). Adjuvant Treatment of Colorectal Cancer. CA Cancer J Clin
57: 168-185
[Abstract][Full Text]
Keime-Guibert, F., Chinot, O., Taillandier, L., Cartalat-Carel, S., Frenay, M., Kantor, G., Guillamo, J.-S., Jadaud, E., Colin, P., Bondiau, P.-Y., Menei, P., Loiseau, H., Bernier, V., Honnorat, J., Barrie, M., Mokhtari, K., Mazeron, J.-J., Bissery, A., Delattre, J.-Y., the Association of French-Speaking Neuro-Oncologis,
(2007). Radiotherapy for Glioblastoma in the Elderly. NEJM
356: 1527-1535
[Abstract][Full Text]
Siu, L. L.
(2007). Clinical Trials in the Elderly -- A Concept Comes of Age. NEJM
356: 1575-1576
[Full Text]
Gopal, A. K., Rajendran, J. G., Gooley, T. A., Pagel, J. M., Fisher, D. R., Petersdorf, S. H., Maloney, D. G., Eary, J. F., Appelbaum, F. R., Press, O. W.
(2007). High-Dose [131I]Tositumomab (anti-CD20) Radioimmunotherapy and Autologous Hematopoietic Stem-Cell Transplantation for Adults >= 60 Years Old With Relapsed or Refractory B-Cell Lymphoma. JCO
25: 1396-1402
[Abstract][Full Text]
Kumar, A., Soares, H. P., Balducci, L., Djulbegovic, B.
(2007). Treatment Tolerance and Efficacy in Geriatric Oncology: A Systematic Review of Phase III Randomized Trials Conducted by Five National Cancer Institute-Sponsored Cooperative Groups. JCO
25: 1272-1276
[Abstract][Full Text]
Jackman, D. M., Yeap, B. Y., Lindeman, N. I., Fidias, P., Rabin, M. S., Temel, J., Skarin, A. T., Meyerson, M., Holmes, A. J., Borras, A. M., Freidlin, B., Ostler, P. A., Lucca, J., Lynch, T. J., Johnson, B. E., Janne, P. A.
(2007). Phase II Clinical Trial of Chemotherapy-Naive Patients >= 70 Years of Age Treated With Erlotinib for Advanced Non-Small-Cell Lung Cancer. JCO
25: 760-766
[Abstract][Full Text]
Langer, C. J.
(2007). Mind Your Elders: Therapeutic Implications of Epidermal Growth Factor Receptor Inhibition in Older Patients With Advanced Non-Small-Cell Lung Cancer. JCO
25: 751-753
[Full Text]
Travers, J., Marsh, S., Williams, M., Weatherall, M., Caldwell, B., Shirtcliffe, P., Aldington, S., Beasley, R.
(2007). External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?. Thorax
62: 219-223
[Abstract][Full Text]
Hilpert, F, du Bois, A, Greimel, E., Hedderich, J, Krause, G, Venhoff, L, Loibl, S, Pfisterer, J
(2007). Feasibility, toxicity and quality of life of first-line chemotherapy with platinum/paclitaxel in elderly patients aged >=70 years with advanced ovarian cancer--a study by the AGO OVAR Germany. Ann Oncol
18: 282-287
[Abstract][Full Text]
Ko, D. T., Krumholz, H. M., Wang, Y., Foody, J. M., Masoudi, F. A., Havranek, E. P., You, J. J., Alter, D. A., Stukel, T. A., Newman, A. M., Tu, J. V.
(2007). Regional Differences in Process of Care and Outcomes for Older Acute Myocardial Infarction Patients in the United States and Ontario, Canada. Circulation
115: 196-203
[Abstract][Full Text]
LoConte, N. K.
(2007). Disparities in Cancer Care for Older Adults. J Oncol Pract
3: 51-51
[Full Text]
Repetto, L., Audisio, R. A.
(2006). Elderly Patients Have Become the Leading Drug Consumers: It's High Time to Properly Evaluate New Drugs Within the Real Targeted Population. JCO
24: e62-e63
[Full Text]
Smith, B. D., Haffty, B. G., Hurria, A., Galusha, D. H., Gross, C. P.
(2006). Postmastectomy Radiation and Survival in Older Women With Breast Cancer. JCO
24: 4901-4907
[Abstract][Full Text]
Hurria, A., Fleming, M. T., Baker, S. D., Kelly, Wm. K., Cutchall, K., Panageas, K., Caravelli, J., Yeung, H., Kris, M. G., Gomez, J., Miller, V. A., D'Andrea, G., Scher, H. I., Norton, L., Hudis, C.
(2006). Pharmacokinetics and toxicity of weekly docetaxel in older patients.. Clin. Cancer Res.
12: 6100-6105
[Abstract][Full Text]
Dominguez-Ventura, A., Allen, M. S., Cassivi, S. D., Nichols, F. C. III, Deschamps, C., Pairolero, P. C.
(2006). Lung cancer in octogenarians: factors affecting morbidity and mortality after pulmonary resection.. Ann. Thorac. Surg.
82: 1175-1179
[Abstract][Full Text]
Lamont, E. B., Herndon, J. E. II, Weeks, J. C., Henderson, I. C., Earle, C. C., Schilsky, R. L., Christakis, N. A.
(2006). Measuring disease-free survival and cancer relapse using Medicare claims from CALGB breast cancer trial participants (companion to 9344).. JNCI J Natl Cancer Inst
98: 1335-1338
[Abstract][Full Text]
Coca, S. G., Krumholz, H. M., Garg, A. X., Parikh, C. R.
(2006). Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease.. JAMA
296: 1377-1384
[Abstract][Full Text]
Goldberg, R. M., Tabah-Fisch, I., Bleiberg, H., de Gramont, A., Tournigand, C., Andre, T., Rothenberg, M. L., Green, E., Sargent, D. J.
(2006). Pooled Analysis of Safety and Efficacy of Oxaliplatin Plus Fluorouracil/Leucovorin Administered Bimonthly in Elderly Patients With Colorectal Cancer. JCO
24: 4085-4091
[Abstract][Full Text]
Ford, B. M., Evans, J. S., Stoffel, E. M., Balmana, J., Regan, M. M., Syngal, S.
(2006). Factors associated with enrollment in cancer genetics research.. Cancer Epidemiol. Biomarkers Prev.
15: 1355-1359
[Abstract][Full Text]
Elkin, E. B., Hurria, A., Mitra, N., Schrag, D., Panageas, K. S.
(2006). Adjuvant Chemotherapy and Survival in Older Women With Hormone Receptor-Negative Breast Cancer: Assessing Outcome in a Population-Based, Observational Cohort. JCO
24: 2757-2764
[Abstract][Full Text]
Cohen, H. J., Muss, H. B.
(2006). The Cancer and Leukemia Group B Cancer in the Elderly Committee: Addressing a Major Cancer Need.. Clin. Cancer Res.
12: 3606s-3611s
[Abstract][Full Text]
Lichtman, S. M., Hollis, D., Miller, A. A., Rosner, G. L., Rhoades, C. A., Lester, E. P., Millard, F., Byrd, J., Cullinan, S. A., Rosen, D. M., Parise, R. A., Ratain, M. J., Egorin, M. J.
(2006). Prospective Evaluation of the Relationship of Patient Age and Paclitaxel Clinical Pharmacology: Cancer and Leukemia Group B (CALGB 9762). JCO
24: 1846-1851
[Abstract][Full Text]
Raghavan, D., Suh, T.
(2006). Cancer in the Elderly Population: The Protection Racket. JCO
24: 1795-1796
[Full Text]
Burdette-Radoux, S., Muss, H. B.
(2006). Adjuvant chemotherapy in the elderly: whom to treat, what regimen?. The Oncologist
11: 234-242
[Abstract][Full Text]
Gotay, C. C.
(2006). Increasing Trial Generalizability. JCO
24: 846-847
[Full Text]
Freyer, G., Braud, A.-C., Chaibi, P., Spielmann, M., Martin, J.-P., Vilela, G., Guerin, D., Zelek, L.
(2006). Dealing with metastatic breast cancer in elderly women: results from a French study on a large cohort carried out by the 'Observatory on Elderly Patients'. Ann Oncol
17: 211-216
[Abstract][Full Text]
Unger, J. M., Coltman, C. A. Jr, Crowley, J. J., Hutchins, L. F., Martino, S., Livingston, R. B., Macdonald, J. S., Blanke, C. D., Gandara, D. R., Crawford, E. D., Albain, K. S.
(2006). Impact of the Year 2000 Medicare Policy Change on Older Patient Enrollment to Cancer Clinical Trials. JCO
24: 141-144
[Abstract][Full Text]
Goss, C. H., Rubenfeld, G. D., Ramsey, B. W., Aitken, M. L.
(2006). Clinical Trial Participants Compared with Nonparticipants in Cystic Fibrosis. Am. J. Respir. Crit. Care Med.
173: 98-104
[Abstract][Full Text]
Jatoi, A., Hillman, S., Stella, P., Green, E., Adjei, A., Nair, S., Perez, E., Amin, B., Schild, S. E., Castillo, R., Jett, J. R.
(2005). Should Elderly Non-Small-Cell Lung Cancer Patients Be Offered Elderly-Specific Trials? Results of a Pooled Analysis From the North Central Cancer Treatment Group. JCO
23: 9113-9119
[Abstract][Full Text]
Doyle, J. J., Neugut, A. I., Jacobson, J. S., Grann, V. R., Hershman, D. L.
(2005). Chemotherapy and Cardiotoxicity in Older Breast Cancer Patients: A Population-Based Study. JCO
23: 8597-8605
[Abstract][Full Text]
Harter, P., du Bois, A., Schade-Brittinger, C., Burges, A., Wollschlaeger, K., Gropp, M., Schmalfeldt, B., Huober, J., Staehle, A., Pfisterer, J., for the Study Coordination Group of the AGO-OVAR,
(2005). Non-enrolment of ovarian cancer patients in clinical trials: reasons and background. Ann Oncol
16: 1801-1805
[Abstract][Full Text]
Wakelee, H., Belani, C. P.
(2005). Optimizing First-Line Treatment Options for Patients with Advanced NSCLC. The Oncologist
10: 1-10
[Abstract][Full Text]
Mullins, C. D., Blatt, L., Gbarayor, C. M., Yang, H.-W. K., Baquet, C.
(2005). Health disparities: A barrier to high-quality care. Am J Health Syst Pharm
62: 1873-1882
[Abstract][Full Text]
Wasil, T., Lichtman, S. M.
(2005). Clinical Pharmacology Issues Relevant to the Dosing and Toxicity of Chemotherapy Drugs in the Elderly. The Oncologist
10: 602-612
[Abstract][Full Text]
Gridelli, C., Shepherd, F. A.
(2005). Chemotherapy for Elderly Patients With Non-Small Cell Lung Cancer: A Review of the Evidence. Chest
128: 947-957
[Abstract][Full Text]
Brunello, A., Basso, U., Pogliani, C., Jirillo, A., Ghiotto, C., Koussis, H., Lumachi, F., Iacobone, M., Vamvakas, L., Monfardini, S.
(2005). Adjuvant chemotherapy for elderly patients (>=70 years) with early high-risk breast cancer: a retrospective analysis of 260 patients. Ann Oncol
16: 1276-1282
[Abstract][Full Text]
Gross, C. P., Herrin, J., Wong, N., Krumholz, H. M.
(2005). Enrolling Older Persons in Cancer Trials: The Effect of Sociodemographic, Protocol, and Recruitment Center Characteristics. JCO
23: 4755-4763
[Abstract][Full Text]
Lamont, E. B., Herndon, J. E. II, Weeks, J. C., Henderson, I. C., Lilenbaum, R., Schilsky, R. L., Christakis, N. A., for the Cancer and Leukemia Group B,
(2005). Criterion Validity of Medicare Chemotherapy Claims in Cancer and Leukemia Group B Breast and Lung Cancer Trial Participants. JNCI J Natl Cancer Inst
97: 1080-1083
[Abstract][Full Text]
Gross, C. P., Wong, N., Dubin, J. A., Mayne, S. T., Krumholz, H. M.
(2005). Enrollment of Older Persons in Cancer Trials After the Medicare Reimbursement Policy Change. Arch Intern Med
165: 1514-1520
[Abstract][Full Text]
Chen, Y.-M., Perng, R.-P., Shih, J.-F., Tsai, C.-M., Whang-Peng, J.
(2005). Chemotherapy for Non-small Cell Lung Cancer in Elderly Patients. Chest
128: 132-139
[Abstract][Full Text]
Townsley, C., Pond, G. R., Peloza, B., Kok, J., Naidoo, K., Dale, D., Herbert, C., Holowaty, E., Straus, S., Siu, L. L.
(2005). Analysis of Treatment Practices for Elderly Cancer Patients in Ontario, Canada. JCO
23: 3802-3810
[Abstract][Full Text]
Gross, C.P., Krumholz, H.M.
(2005). Impact of Managed Care on Cancer Trial Enrollment. JCO
23: 3811-3818
[Abstract][Full Text]
Rossi, A., Maione, P., Colantuoni, G., Guerriero, C., Ferrara, C., Del Gaizo, F., Nicolella, D., Gridelli, C.
(2005). Treatment of Small Cell Lung Cancer in the Elderly. The Oncologist
10: 399-411
[Abstract][Full Text]
Sastre, J., Marcuello, E., Masutti, B., Navarro, M., Gil, S., Anton, A., Abad, A., Aranda, E., Maurel, J., Valladares, M., Maestu, I., Carrato, A., Vicent, J. M., Diaz-Rubio, E.
(2005). Irinotecan in Combination With Fluorouracil in a 48-Hour Continuous Infusion As First-Line Chemotherapy for Elderly Patients With Metastatic Colorectal Cancer: A Spanish Cooperative Group for the Treatment of Digestive Tumors Study. JCO
23: 3545-3551
[Abstract][Full Text]
Townsley, C. A., Selby, R., Siu, L. L.
(2005). Systematic Review of Barriers to the Recruitment of Older Patients With Cancer Onto Clinical Trials. JCO
23: 3112-3124
[Abstract][Full Text]
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