Age cutoffs clinical oncology guide biomarkerslines

Are the chronological age cutoffs used in clinical oncology guidelines biologically meaningful?

by Neil Carleton and Priscilla F. McAuliffe

Dec 1^st 2022
4 mins
Nat Rev Clin Oncol. 2022 Dec; 19(12): 745–746.

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Summary

Age is a significant risk factor for cancer, influencing tumour biology, treatment recommendations, and therapy response.
Breast cancer incidence peaks around 70 years of age, with over one-third of diagnoses in this age group.
Clinical guidelines vary in defining "older" patients, using age cutoffs like 65 and 70 years, leading to inconsistency.
Historical and societal factors, such as retirement age, influenced these age cutoffs rather than biological relevance.
The aging process is dynamic and varies among individuals, complicating the use of chronological age as a sole factor in guidelines.
There is ongoing research to identify biomarkers of aging that could provide a more accurate basis for clinical guidelines.
Clinical trial enrollment often under-represents older patients, and varying age cutoffs in trials further complicate standardization.
Proposed shift to using frailty-based instead of chronological age cutoffs in guidelines to better reflect patient health status.
Efforts to standardize age definitions and integrate biological, clinical, and chronological criteria are needed to improve guidelines.

Cancer is predominantly a disease of ageing: the incidence of many epithelial tumours increases with age. With a peak incidence at around 70 years of age, breast cancer is no exception. Moreover, more than one-third of all breast tumours are diagnosed in patients over this age. In older patients with breast cancer, the biology of the disease has a more indolent phenotype that reflects an enrichment of hormone receptor-positive tumours, a phenomenon that has been recognized for decades. A question that remains to be answered, however, is whether this transition occurs at a discrete age or whether breast cancer biology changes gradually with age after menopause.....

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Age, cutoffs, clinical oncology guide, biomarkers