Is it time to move on to the next generation of clinical trials in older patients with cancer?

Abstract

Lung cancer is the leading cause of cancer death worldwide and is commonly diagnosed in older patients, with the median age of diagnosis in the UK being 71 years (IQR 62–75).1 Treatment rates, both curative and palliative in intent, decrease with age,2 the reasons for which are complex and might include complications in treatment delivery due to comorbidities, poor functional status, and frailty, which are common in older people. These problems might be more marked in squamous-cell lung cancer, which accounts for 25% of cases of non-small-cell lung cancer (NSCLC), as this type of lung cancer commonly arises in patients who are currently or have previously been smokers and might be associated with smoking-related diseases such as chronic obstructive pulmonary disease, ischaemic heart disease, and peripheral vascular disease.