Goal and Objectives

In this workshop senior cancer center representatives (i.e., center directors, individual researchers, science administrators, scientific program directors) explored the expertise and resources of the cancer centers that can be organized to generate research on the aging/cancer interface. The NCI Cancer Centers Program supports major academic and research institutions throughout the United States to sustain broad-based, coordinated, interdisciplinary programs in cancer research, and also promotes inter-institute studies and collaborations among investigators in oncology and geriatric medicine and investigators of the biology of aging and cancer. The workshop setting was meant to provide a forum for constructive brainstorming and to obtain a productive exchange of ideas among participants from varying disciplines and professions who were invited to share their perspectives.

The goal of the workshop was to identify a concise set of research priorities to facilitate the interface of aging and cancer research so that scientific pathways can be established to reduce the magnitude of the cancer burden for older Americans.

The objectives of the NIA/NCI cosponsored workshop were to:

1. Identify promising scientific areas at the aging/cancer research interface that could be pursued in the cancer centers, given their unique resources and expertise.
    
2. Recommend research opportunities in aging and cancer research (considering each working group's theme) that will advance medical progress at the aging/cancer research inter face. In each working group, the top three research priorities were selected.
    
3. Suggest various strategies and approaches for integrating aging and cancer research on behalf of older persons (i.e., a research plan of action).

Charge to the Working Groups

• Each working group was charged with nominating the three highest research priorities out of all opportunities and needs discussed.
   
• Group deliberations on the research themes also addressed the following factors in their report during the plenary session:
   
  • Barriers to research progress (e.g., lack of sufficiently trained researchers and clinicians, insufficient technology, organizational infrastructure, inadequate funding, complexity of the older patient's situation, research problem definition, lack of leadership or expertise)
     
  • Mechanisms to facilitate research progress (e.g., evaluation tools to assist in the assessment of prognosis and treatment of older cancer patients, development and standardization of alterations or modifications of cancer treatment modalities in older patients because of comorbidity, ways to enhance participation of older persons in clinical studies, novel funding mechanisms as incentives for conducting research on cancer in the elderly)

Research Topics

Many excellent ideas emanated from the August 10, 2000, workshop planning meeting and are incorporated within the seven themes for the breakout sessions. Other ideas were introduced by individuals in the breakout group discussions. Among the suggestions for themes that emerged within the planning group were:

• patterns of care studies;
• pharmacology of anti-cancer agents in older patients;
• prospective studies of surgical and radiation treatment in individuals with varying age-related functional limitations;
• activities of new drug and biologic anti-cancer agents in older patients;
• follow-up studies on adverse effects of treatment in older and younger patients;
• single institution and/or multicenter clinical trials;
• Phase IV trials (standard therapy outcome) to improve management of older cancer patients;
• characterization of older patients ineligible for treatment protocols;
• correlative research studies;
• cancer-site specific studies (e.g., refinement of current characterization of different tumors in relation to aging);
• effective management of older cancer patients with preexisting chronic conditions and concurrent diseases (i.e., comorbidity);
• studies of mechanisms of carcinogenesis and senescence and their overlap;
• coping with psychosocial, social, and medical effects of cancer and its treatment; and
• palliative care, pain management, and end of life issues.

The cancer centers also have many existing databases that could be examined for insights into generate hypotheses (tissue bank data) and treatment patterns (e.g., in-house tumor registries).

Research Themes Selected