Cancer Research for Older Adults: Unlocking Key Insights from SIOG 2025
Imagine a world where cancer research truly understands the unique needs and priorities of older adults. Well, that's exactly what the SPARC Roundtable at the SIOG 2025 Annual Conference set out to explore. Building on the momentum of last year's focus on patient-centred care, this year's meeting delved into the heart of the matter: how can we redefine success in cancer care for older patients?
The Status Quo: Prioritizing Survival Over Quality of Life
In traditional oncology research, survival and tumor response have taken center stage. However, many older adults value their quality of life, symptom relief, communication, independence, and the ability to stay in their homes just as much, if not more. So, how can we reshape research to align with these priorities?
From Tokenism to True Partnership: A Paradigm Shift
The first part of the session explored a crucial question: how can we move beyond the mere involvement of patients in research to genuine partnership? Speakers shared inspiring models where older adults and caregivers are integral from the very beginning. They help shape the research question, select primary outcomes, design consent forms, and even co-author publications. In these examples, patient groups are not an afterthought but a driving force, choosing their members and projects, training staff, and interpreting data.
Ingredients for a Successful Partnership
Several key ingredients emerged for a true partnership:
- Patient groups should lead their own structures, not be directed by researchers.
- Patient partners should be treated as co-investigators, with appropriate compensation and support.
- Research teams must be flexible, shifting priorities based on patient feedback.
These experiences have transformed research teams, moving from investigator-driven designs to co-developed studies that integrate quantitative and qualitative data.
Redefining Success: Endpoints and PROMs for Older Adults
The Roundtable's second part focused on how endpoints and patient-reported outcome measures (PROMs) can better reflect the realities of older adults with cancer. Key challenges were discussed, including endpoints that miss what truly matters to patients, the lack of geriatric-specific tools, higher dropout rates, and PROMs that are not age-appropriate.
Participants highlighted ongoing efforts to refine geriatric oncology endpoints and update position papers to guide trial design. There was a strong emphasis on ensuring that patient-reported data is not just collected but also used in regulatory decisions and clinical practice, giving it real influence.
Shared Responsibility: Regulators, Industry, and Funders
Regulatory representatives noted that while guidelines call for diverse trial populations, older adults, especially those with multiple comorbidities, remain underrepresented. Sponsors fear including frailer patients might complicate data, even though these patients are the ones who will likely use the medicines.
Multi-stakeholder initiatives are now addressing this by exploring ways to include dedicated cohorts of older adults in pivotal studies, using real-world data, and aligning regulators, HTA bodies, and payers on expectations for evidence in older populations.
Industry participants described internal efforts to include more older adults in trials, acknowledging progress is slow and often invisible in headline results.
Funders, especially philanthropic organizations, were highlighted as catalysts, requiring meaningful patient engagement and reviewing how patient partnerships are structured.
The Role of Patient Advocates and Professionals
Patient advocates stressed that partnership is a shared responsibility. While older adults are willing to advocate, they shouldn't bear the burden alone. Clinicians, researchers, and others have a duty to create systems where older adults can participate meaningfully.
Advocates also emphasized the wealth of existing tools and network models that can be adapted, building on a long history of patient-centred outcomes research.
Moving Forward: Building Age-Inclusive Evidence
There was a consensus across the Roundtable that oncology research for older adults must evolve. It's not just about treating this population as an afterthought; it's about recognizing them as the core of real-world cancer care.
This evolution requires embedding older adults and caregivers throughout the research lifecycle, developing tailored endpoints and PROMs, redesigning trials to include diverse patients, and aligning stakeholders around age-inclusive evidence.
The SIOG 2025 Message: Redefining Success
The message from SIOG 2025 is clear: redefining success in oncology for older adults means measuring what truly matters to them and conducting research with them, not just about them. It's about ensuring their voices are heard and their experiences are reflected in research outcomes.
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