Wednesday, March 31, 2021 Hernandez-Torres C, Cheung WY, Kong S, O'Callaghan CJ, Hsu T. Accrual of older adults to cancer clinical trials led by the Canadian cancer trials group - Is trial design a barrier? Journal of Geriatric Oncology 11: 455-62, 2020. https://www.sciencedirect.com/science/article/pii/S1879406819301456?via%3Dihub Older adults (OA), aged 65 years and over, are under-represented in studies. Strict exclusion criteria have been identified as a potential barrier to accrual of OA. This study aims to determine: 1) whether accrual of OA to trials led by the Canadian Cancer Trials Group (CCTG) has increased since 2003; 2) whether exclusion criteria have broadened over time; 3) whether exclusion criteria are associated with lower accrual of OA. Results Sixty-nine trials involving 34,957 patients were included. Accrual of OA to trials remained low compared to OA diagnosed with cancer in Canada (40.8% vs. 56.1%, p < .001). There was a small increase in the accrual of OA since 2003 (42.8% vs. 39.3%, p = .04). There was no relaxation of exclusion criteria over time. Studies initiated prior to 2003, breast cancer studies and studies with exclusion criteria based on renal dysfunction were associated with lower accrual of OA (p < .05). Central nervous system studies were associated with higher accrual of OA (p = .03). Conclusion OA remain under-represented in trials. While there has been minimal change in exclusion criteria over time, renal dysfunction was the only exclusion criteria associated with lower accrual of OA.
