Geriatric Oncology

Older adults are systematically underrepresented in clinical trials, and treatment decisions are frequently extrapolated from studies of younger, selected populations. Underrepresentation of older adults in trials creates a meaningful risk of both overtreatment and undertreatment in patients with ageing-related vulnerabilities. Selection bias may arise in MAPLE2 because patients with cognitive impairment or limited digital literacy may be less likely to participate, potentially inflating feasibility estimates. In Japan, individuals aged 70 and over comprise the majority of cancer patients.