EORTC Perspective Urges Patient Preferences as Clinical Trial Endpoints in Geriatric Oncology
核心洞察
A new EORTC perspective published in the European Journal of Cancer (搜索) calls for patient-preference studies to be embedded in oncology trials alongside survival, toxicity and quality of life.
In a secondary analysis of the GAP70+ randomised trial, 71% of older patients prioritised maintaining health-related quality of life over prolonging survival.
Older adults remain underrepresented in oncology trials despite representing a growing share of people diagnosed with cancer (搜索) later in life.
Older adults with cancer (搜索) should have their treatment preferences measured as a clinical-trial endpoint, according to a new perspective from the EORTC Older Adult Council and the EORTC Quality of Life Group published in the European Journal of Cancer (搜索). The paper argues that patient-preference studies should be embedded in oncology trials alongside survival, toxicity and health-related quality of life (HRQoL), addressing a gap in how trial evidence reflects what older patients actually value.
The proposal rests on a straightforward premise articulated by Paolo Bossi, Head of the Head and Neck Medical Oncology Unit and Associate Professor of Medical Oncology at Humanitas University (搜索) and Humanitas Cancer Center (搜索): if older adults are asked to accept the risks of research, clinical trials should also ask what outcomes matter most to them.
Underrepresentation and Divergent Priorities
Older adults remain underrepresented in oncology trials even as the population ages and more people are diagnosed with cancer (搜索) later in life. According to the perspective, their priorities may differ from those of younger patients when balancing survival, toxicity, function and HRQoL.
The authors point to a secondary analysis of the GAP70+ randomised trial, in which 71% of older patients prioritised maintaining HRQoL over prolonging survival. While survival and HRQoL consistently rank among the highest-priority outcomes, the paper notes that the acceptable trade-off between them is individual — a nuance that conventional trial endpoints are not designed to capture.
What Conventional Endpoints Miss
The perspective contends that conventional endpoints alone do not show how patients value benefits, risks and treatment burden. Integrating preference data is intended to support benefit–risk assessments that reflect patients' lived experience, align treatment recommendations with what older adults value, strengthen shared decision-making, and produce a more informative evidence base for geriatric oncology.
The authors also emphasise that preference-elicitation methods must be both rigorous and feasible for older adults, a methodological requirement they frame as central to the proposal rather than incidental.
Scope and Authorship
The paper is a perspective article and not a new interventional trial. Its central proposal, as summarised by Bossi, is that trials should formally ask older adults which outcomes matter most to them.
The article is titled "Integrating patient preferences into clinical trial outcomes for older adults with cancer (搜索): A perspective from the EORTC Older Adult Council and Quality of Life Group." Pierluigi Bonomo is the lead author, and co-authors include Lissandra Dal Lago, Luigi Lim, Paolo Bossi, Ananda Plate, Heike Schmidt, Jaap C. Reijneveld, Pete Wheatstone and Madeline Pec.
Lissandra Dal Lago, Medical Oncologist at CHIREC Hospital Group (搜索), described the publication as the result of ongoing efforts by an interdisciplinary team and invited the research community working with older adults with cancer (搜索) to request reprints and share the paper in the coming weeks.