Université Paris Est Créteil, UFR Médecine, 8 Rue du Général Sarrail, 94000 Créteil, France; Hôpital Henri Mondor, CEpiA/Unité de Santé publique, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
Université Paris Est Créteil, UFR Médecine, 8 Rue du Général Sarrail, 94000 Créteil, France; Hôpital Henri Mondor, CEpiA/Unité de Santé publique, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
J Geriatr Oncol. 2021 Jul;12(6):945-951. doi: 10.1016/j.jgo.2021.03.002. Epub 2021 Mar 11.
The under-representation of older patients in cancer trials remains an important obstacle to the generation of data on efficacy and safety in this growing patient population. In France, geriatric oncology coordination units (UCOGs) have been created to help oncologists and geriatricians work together on research, best practice, and continuing medical education. Taking these units as a case study, this paper sheds light on the collaboration between geriatricians and oncologists in the inclusion process of older patients in cancer trials.
Empirical data were gathered in a series of sociological interviews with all 16 oncologists, geriatricians and unit coordinators in the five UCOGs in the greater Paris region of France.
The case of French geriatric oncology coordination units shows the gap between professional research cultures in oncology and geriatrics that may account for the low observed inclusion rates. It is easier to include patients in randomized clinical trials than in observational studies. UCOGs have the potential to improve research in geriatric oncology by catalyzing the development and implementation of effective collaboration tools (such as frailty assessments). The units also have the potential to promote Phase IV trials and observational research that are suitable for older patients with cancer.
Bridging the cultural gap between oncologists (the dominant force in setting the cancer research agenda) and geriatricians (a source of specific knowledge and know-how) is essential for producing relevant trial protocols that match the specific yet diverse features of older patient populations.
在癌症试验中，老年患者代表性不足仍然是一个重要障碍，阻碍了在这一不断增长的患者群体中生成疗效和安全性数据。在法国，设立了老年肿瘤协调单位（UCOG），以帮助肿瘤学家和老年病学家在研究、最佳实践和继续医学教育方面开展合作。本文以这些单位为例，阐明了在将老年患者纳入癌症试验的过程中，老年病学家和肿瘤学家之间的合作。
在法国大巴黎地区的五个 UCOG 中，对所有 16 名肿瘤学家、老年病学家和单位协调员进行了一系列社会学访谈，收集了实证数据。
法国老年肿瘤学协调单位的案例表明，肿瘤学和老年病学的专业研究文化之间存在差距，这可能是观察到的纳入率较低的原因。纳入随机临床试验比纳入观察性研究更容易。UCOG 有可能通过促进有效的合作工具（如虚弱评估）的开发和实施，改善老年肿瘤学的研究。这些单位还有可能促进适合老年癌症患者的第四阶段试验和观察性研究。
弥合肿瘤学家（制定癌症研究议程的主导力量）和老年病学家（特定知识和专业技能的来源）之间的文化差距，对于制定与老年患者群体的特定但多样化特征相匹配的相关试验方案至关重要。
