The vast majority of clinical trials have an upper age limit ranging between 75 to 85 years. It is extremely rare to find a trial today that accrues patients that are 89 years old which is the upper limit of any trial I have found on clinicaltrials.gov and those trials occurred more than a decade ago. Phase I and II trials accept healthier and younger patients and are the ones more likely to be open label trials where all patients receive the test drug. Some phase II trials are randomized and can be single or double blinded to mask knowing who is receiving the drug until the trial is concluded.

Phase III trials accept less healthy patients although with limits in age restriction and the co-morbidities that can result in exclusion. All phase III trials are randomized. A computer does the selection so the patient nor the oncologist has any say in who is in the test arm and who is in the control arm receiving standard of care.

There are surgical oncologists who will perform the Whipple and Distal Pancreatectomy with splenectomy on patients of advanced years. The criteria is not age but the ECOG health status of that patient, generally being 0 to 1 and no serious co-morbidities. The famous Whipple surgeon John Cameron who practiced at Johns Hopkins in Baltimore and now retired performed a Whipple on the oldest patient being 103 years old. Flavio Rocca MD in Portland, Oregon did a Whipple on a patient that was 94 years old. John Chabot MD of the Pancreas Center at Columbia Presbyterian also does Whipple surgery on patient of advanced years.

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