Oncology Frontier: Being older than 60 or 65 is a very common exclusion criterion of clinical trials， so it’s hard and somewhat arbitrary to make a treatment decision for this subgroup of population. Could you give us some suggestions on how to include the aged in a clinical trial or how to develop clinical trials focused on older patients?

　　《肿瘤瞭望》：年纪大于60或65是临床试验入组的常见排除标准，因此为老年患者制订治疗方案时有困难，有时甚至是随意且武断的。如何将老年人纳入临床试验，或如何开展老年人的临床试验，您能给我们一些建议吗？

　　Dr Muss: I think the days of excluding people according to age should be over. In the United States， we can’t do that anymore. We should allow any age. If the doctor and patient feel the clinical trial works in their favor， then that patient should be allowed to sign on. The first thing is not exclude age as a number. Secondly， there should not be exclusion criteria like kidney function and so on unless it is directly related to the treatment. If you have a treatment that metabolizes through the kidney or causes kidney damage then any person of any age should be excluded but not as a blanket exclusion which includes age. Then we need to teach doctors about the fact that a lot of healthy older people can tolerate these treatments and encourage the doctors， nurses and associated staff to offer clinical trials to their older patients. There is a definite age bias. Education will be a key part of this.

　　Muss教授：我想，根据年龄将患者排除（在试验之外）的日子应该终结了。在美国，这样再也行不通了。临床试验应纳入任何年龄的受试者。只要医生和患者认为某个临床试验有利于患者的利益，那么就应该允许该患者进行登记。首先，不要依据某个数值来除外老年人。第二，不应该有类似肾功能之类的排除标准，除非它与治疗直接相关。如果某种药物通过肾脏代谢或导致肾损伤，那么，任何年龄的任何人都应除外，而不是一概排斥年龄因素。第三，我们需要教育医生一个事实——很多健康的老年人都能耐受这些治疗，并鼓励医生、护士和相关人员向老年患者提供参加临床试验的机会。毫无疑问，目前存在年龄偏见，教育将是解决这个问题的关键部分。

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