Multidisciplinary treatment planning for older people with lung cancer

Establishment and Validation of a Multidisciplinary Team (MDT)-Based Umbrella Decision-making and Treatment Model for Geriatric Lung Cancer Patients

We will test a team-based approach that uses geriatric assessments to create personalized treatment plans for people aged 60–90 with newly diagnosed lung cancer to see if it improves 3-year progression-free survival compared with past patients.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 2000 (estimated)
• Ages: 60 Years to 70 Years
• Sex: All
• Sponsor: West China Hospital (Academic / other)
• Drugs / interventions: chemotherapy, immunotherapy
• Locations: 1 site (Chengdu, Sichuan)
• Trial ID: NCT07509333 on ClinicalTrials.gov

What this trial studies

This is a prospective, single-arm interventional program at West China Hospital enrolling 2,000 patients aged 60–90 with newly diagnosed non-small cell or small cell lung cancer. Each patient receives a comprehensive geriatric assessment and an individualized treatment plan created by a multidisciplinary team including thoracic surgeons, geriatricians, oncologists, pulmonologists, rehabilitation therapists, and radiologists. Treatment options span surgery, ablation, stereotactic body radiotherapy, neoadjuvant immunochemotherapy, targeted therapy, and best supportive care, and outcomes will be compared to a historical control cohort using propensity score matching. The primary outcome is 3-year progression-free survival, with secondary endpoints of overall survival, objective response rate, quality of life, and adverse events.

Who should consider this trial

Good fit: Ideal candidates are people aged 60–90 with histologically or cytologically confirmed NSCLC or SCLC (stage I–IV), ECOG performance status 0–2, estimated life expectancy ≥3 months, and able to attend West China Hospital for assessments and at least one planned treatment.

Not a fit: Patients with unclear pathology, recent other primary malignancies, ECOG >2, or who are too frail to tolerate any planned treatment are unlikely to gain benefit from this model.

Why it matters

Potential benefit: If successful, this approach could provide more personalized care for older lung cancer patients, improving progression-free survival, overall survival, and quality of life.

How similar studies have performed: Multidisciplinary team approaches have improved decision-making and outcomes in lung cancer care in prior reports, but integrating comprehensive geriatric assessment into an umbrella decision model for elderly patients is relatively novel and lacks large prospective validation.

Eligibility criteria

Inclusion Criteria:

1. Age 60 to 90 years.
2. Histologically or cytologically confirmed non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC).
3. Clinical stage I-IV (according to the 9th edition of the IASLC TNM staging system).
4. ECOG Performance Status 0-2.
5. Estimated life expectancy ≥ 3 months.
6. Able to tolerate baseline examinations (including CT, MRI, pulmonary function tests) and at least one planned treatment modality (surgery, ablation, SBRT, etc.) as assessed by the investigator.
7. Patients or their legal representatives provide written informed consent and commit to completing the full follow-up schedule (including questionnaires and functional assessments).
8. Other conditions deemed suitable by the investigator.

Exclusion Criteria:

1. History of other primary malignancies within the past 5 years (except non-melanoma skin cancer or carcinoma in situ of the cervix).
2. Unclear pathological diagnosis (no definite histologic or cytologic evidence) or post-enrollment pathological review excludes lung cancer.
3. Severe psychiatric disorders (e.g., Alzheimer's disease, schizophrenia) or cognitive impairment (MMSE score \< 20) that interferes with questionnaire completion or treatment decision-making communication.
4. Contraindications to study-related examinations or treatments:

   4.1Known contraindication to iodine-based contrast agents or MRI (e.g., incompatible metallic implants).

   4.2Known severe allergy to any of the essential therapeutic agents (e.g., chemotherapy, targeted drugs) involved in the study.
5. Severe organ dysfunction (e.g., Child-Pugh class C cirrhosis, end-stage renal disease without dialysis) that precludes tolerability of baseline examinations or any treatment.
6. No fixed residential address or effective contact information, or family members refuse to assist with follow-up, leading to an estimated follow-up dropout risk \> 50%.
7. Concurrent participation in another interventional clinical trial for lung cancer (observational studies are allowed).
8. Any other condition that, in the opinion of the investigator, makes the patient unsuitable for study participation.

Where this trial is running

Chengdu, Sichuan

• West China Hospital, Sichuan University — Chengdu, Sichuan, China (Recruiting)

Study contacts

• Study coordinator: Yu NA Tong, Master's degree

Conditions Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Small Cell Lung Carcinoma; Elderly; Lung cancer; Geriatric; Multidisciplinary team; Umbrella trial