Dear Editor,

We thank Dr. Narasimhulu and colleagues for the interest in our paper ‘participation of elderly gynecological cancer patients in clinical trials’.

We agree with Dr. Narasimhulu, that it is time to focus on strategies how to improve participation of elderly women in gynecological clinical trials. We fully agree, that it would be most desirable to assume a responsibility by the sponsor to raise more money to assist special needs of the elderly. Furthermore, doctors should carefully assess, whether an older patient is genuinely not suited for a clinical trial due to “objective” comorbidity or just assumed problems because of high age. To avoid negative selection of older patients through managing physicians’ standardized assessment and clear guidance for management within clinical studies will be necessary in the future.