Each year more than 20 000 women are diagnosed with ovarian cancer, more than half of whom are older than 65 years. Older age is associated with increased risk for disease progression and death. With each 5-year increment of age after 65 years, survival diminishes; only 33% of those aged 80 to 84 years survive 1 year after diagnosis.1 Prospective and retrospective studies have demonstrated that with aging comes an increase in treatment-related toxic effects and decrements in survival, receipt of chemotherapy and/or surgery, and involvement in clinical trials.2 The standard treatment of advanced ovarian cancer involves comprehensive cytoreductive surgery and 6 cycles of combination therapy with a platinum and taxane. Long-standing concerns regarding the increased risk of chemotherapy-associated toxic effects in vulnerable older adults owing to physiologic declines in organ function, increased comorbidities, and altered pharmacokinetics have led to shifts in the treatment paradigm for older patients. Older women, especially those 75 years and older, are less likely to receive standard combination therapy. Dose reduction, removal of taxane therapy, and adjustments in schedule are common.3 Delays in chemotherapy administration further decrease survival in older adult patients with ovarian cancer.4
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Wethington SL, Armstrong DK, Gaillard SL. Vulnerable Older Adults With Ovarian Cancer—Time to Stop Undertreating. JAMA Oncol. 2021;7(6):831–833. doi:10.1001/jamaoncol.2021.0468
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: