Oncologists Advocate for Age-Inclusive Licensing of Cancer Treatments

Recent advances in cancer therapy have led to the development of highly effective 'tissue-agnostic' drugs, which target specific molecular markers regardless of the tumor's tissue of origin. Despite their potential, very few of these innovative treatments are approved for use in children. A recent opinion piece in the journal Trends in Cancer emphasizes the need for 'ag(e)nostic' cancer therapies—drugs that are both tissue-agnostic and universally approved across all age groups.

Senior author Razelle Kurzrock, an oncologist at the Medical College of Wisconsin, highlighted the significant unmet need for pediatric access to these advanced treatments. 'Cancer treatment in children remains a critical gap. These drugs are highly effective, and children should have the right to access them,' she stated. She advocates that all cancer drugs should be age-agnostic.

Historically, cancer therapies were chosen based on the tissue where the cancer originated. Modern precision medicine, however, focuses on targeting specific genetic and molecular abnormalities common to different cancers, making it possible to treat diverse tumors with the same drugs. These targeted treatments not only offer increased effectiveness but often have fewer side effects compared to traditional chemotherapy.

Kurzrock explains, 'Cancer is driven by genomic drivers, not by the tissue of origin. Precision treatments are like smart bombs—they specifically attack the abnormality within the cancer.' Nevertheless, as of mid-2024, only 3 cancer drugs are approved for use across all ages, and others are restricted to certain age groups, leaving many pediatric patients without access to potentially life-saving medications.

The reasons for the limited approval of pediatric indications are complex. Pediatric populations are deemed more vulnerable, and there's the challenge of obtaining consent. Furthermore, childhood cancers are rare, limiting opportunities for clinical trials that lead to drug approval. Pediatric oncology often lacks the financial incentives present in adult cancer treatments, decreasing the drive for drug development for children.

Despite these hurdles, scientists and clinicians argue there's no biological or scientific reason why many of these drugs shouldn't be used in children. Children often tolerate medications better than older adults, experiencing fewer side effects, making age-agnostic treatment feasible. Kudek points out, 'If an 80-year-old can safely receive a drug, a 2-year-old should be capable as well.'

Innovative approaches, such as analyzing electronic health record data and pharmacokinetic modeling, could facilitate approvals based on safety and efficacy across age groups, even in the absence of extensive pediatric clinical trials.

Moving forward, the authors advocate for making age-agnostic approvals the standard for precision cancer therapies, which would ensure equitable access and optimize treatment outcomes for all age groups.

For more details, see the article in Trends in Cancer (2025): [DOI: 10.1016/j.trecan.2025.04.015].

Source: https://medicalxpress.com/news/2025-06-cancer-treatments-ages-oncologists.html