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EHA 2026 | Why elderly and frail patients need greater representation in CLL clinical trials
Florian Simon, MD, University Hospital Cologne, Cologne, Germany, discusses the underrepresentation of elderly and frail patients in chronic lymphocytic leukemia (CLL) clinical trials. He explains why greater inclusion of these patients is needed to better inform treatment decisions and highlights the importance of improving both trial representation and global access to effective therapies. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Obviously, as this is somewhat of my research area right now, I’d say elderly and frail patients are still underrepresented in clinical trials. They make up about 20% of patients with CLL, but if you look at the trial distribution, also at post hoc analyses, if you go towards the range of 80 years or plus, you see the numbers dwindling basically. And while some people might say, why are we even talking about this? These are really old patients...
Obviously, as this is somewhat of my research area right now, I’d say elderly and frail patients are still underrepresented in clinical trials. They make up about 20% of patients with CLL, but if you look at the trial distribution, also at post hoc analyses, if you go towards the range of 80 years or plus, you see the numbers dwindling basically. And while some people might say, why are we even talking about this? These are really old patients. If we look at, for example, the frailty right now, we see a patient cohort with 81 years to begin with. And at three years, they’re still more than 80% alive. So you really want to say, is this a patient cohort which we can ignore? And I don’t think we can. So I think it’s really encouraging to see not only this trial, but also other trials which are more and more implementing this. And my aim or my dream for the future would rather be to see that these patients kind of get like a stratification factor within randomized clinical trials to have adequate representation. And maybe in a broader perspective, I’d say we still need to work on drug accessibility for patients across the globe, not only in the developed countries where we are fortunate enough to live in, but also kind of mark a pathway on how to expand treatment accessibility across the globe.
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