Share

World Cancer Day 2025: EORTC’s commitment to older patients

The theme of this year’s World Cancer Day “United in Unique” reflects the massive progress that has been made in tailoring treatment to individual patients over the past thirty years. Advances in genetic profiling have made it possible to offer treatments that are both the most effective in attacking the tumour and the least harmful in terms of side effects. But there is one group that, until recently, has tended to miss out on these advances – the older adults.

Given that cancer is primarily a disease of old age, it may seem strange that there has previously been so little attention given to optimising cancer therapies for such patients. Older patients have historically been limited or even excluded from trials of new treatments for several reasons. They tend to have more comorbidities, they may be frailer than younger patients, and their support systems may be more limited. Yet people age at different rates, and chronological age taken on its own may not be a reliable indicator of an individual’s ability to tolerate treatment. Functional status and cognitive ability may vary widely among people of the same age, making treatment tailored to the individual even more important.

EORTC’s focus on patient-centred research and care rather than drug-centric research has revealed that treatments for younger patients are often not used effectively in older adults.

“Older patients represent the largest segment of the worldwide population with cancer, and as such should be the first target for treatment optimisation,” says EORTC Chief Executive Officer, Dr Denis Lacombe. “We are committed to addressing their needs through a number of innovative programmes.”

A study (EORTC 75111-10114) looked at a new treatment specifically addressed for older, frail patients with HER2-positive advanced breast cancer. This study evaluated dual anti-HER2 treatment with or without metronomic chemotherapy, a less toxic regimen than the traditional taxane regimen in first line setting. Results showed that adding metronomic oral cyclophosphamide to target therapy with trastuzumab plus pertuzumab increased median progression-free survival by seven months. Even though most patients eventually died, those who received the three-drug combination lived longer with an acceptable toxicity profile and quality of life.

One of the most important factors when looking at treatments for older cancer patients is balancing their quality of life with the effectiveness of the therapy. EORTC has developed a tool, the QLQ-ELD14 scale, that is used alongside the QLQ-C30 to specifically cover the quality of life issues of older patients with cancer, and this is now integrated into studies involving them. New endpoints that can holistically capture the quality of life of older patients are being explored for studies involving this patient population, and a new dataset harmonising data collection relevant to older adults is now used in all EORTC trials.

EORTC has also conducted practice-changing studies in older patients, for example in glioblastoma, an aggressive form of brain cancer. The study revealed that certain older patients did not benefit from the standard treatment with temozolomide (TMZ) but needed more personalised therapies. By accurately identifying patients who will not benefit from TMZ, healthcare providers will be able to avoid undue toxicity and focus on more effective treatment strategies for these patients.

“We have shown that we are able to design studies specifically for older cancer patients,” says Dr Lacombe, “but we need also to encourage their recruitment into multi-age trials. Clinicians are often reluctant to suggest trials to older patients, assuming that they are unsuitable. Patients themselves may be reluctant to participate for fear of side effects or a lack of understanding of the scientific process. Far more education of both doctors and patients is needed if we are to serve older cancer patients effectively.”

Looking to the future, the EORTC Older Adult Council, chaired and co-chaired by Lissandra Dal Lago and Paolo Bossi, respectively, has been established specifically to promote clinical and translational research in older people and aims to ensure that older adults are adequately represented in clinical trials.

“Our goal is to study new tools and their use and to share information among oncologists about how these tools can be used to predict toxicities, to identify frailties in the older cancer patient population, and to understand how different treatments behave in different cancer settings in the population. This presents many challenges, but we are determined to continue to provide the best possible treatment for these previously neglected patients,” they say.

Currently, EORTC Older Adult Council is leading research about identifying a frailty index for older patients with cancer that may be implemented in clinical trials and used to define the functionality of the patient and his/her tolerance to the treatment. In straight collaboration with the Quality of Life group, the OAC will also lead an initiative in evaluating patient’s preferences in clinical trials across different tumours.

“Each patient’s cancer experience is unique, and it will take a united effort to create a world where we can look beyond the disease and see the person first,” says Dr Lacombe. “That’s where our efforts to include all groups of people in cancer clinical trials are so important and can really make a difference. We want to see every individual, irrespective of their age or state of health, being able to receive effective, evidence-based treatment that, at the same time, provides the best quality of life possible. And we therefore welcome this year’s World Cancer Day slogan as reflecting those wishes.”

Together, we leave no one behind.

Back to news list

Related News

  • SISAQOL-IMI Consortium Launches Final Recommendations

  • EORTC and Immunocore announce enrolment of first patient onto the only active Phase 3 adjuvant trial in uveal melanoma

  • Minister F. Vandenbroucke visits EORTC Headquarters to strengthen collaborative efforts in clinical cancer research

  • IMMUcan has completed patient enrolment

  • EORTC SPRINT clinical cancer study receives support from Rising Tide Foundation to reduce the burden for patients

  • Pink October at EORTC: Over 60 years of impactful breast cancer research

  • Spotlight on ENA 2024 News

  • Do regulations and policies undermine the social value of independent academic research?

  • EORTC Quality of Life Group’s participation to ISOQOL 2024

  • New Insights into Glioblastoma Treatment for Older Adults Patients