Life extension represents an achievement, but also a new health and social challenge. While people today are living longer and often in better conditions than in the past, advanced age is, however, increasingly marked by chronic and complex diseases, including cancers. Italy is among the longest-living countries in the world and has a progressively aging population: in 1995 there were 6.7 million people over 80; in 2010 there were 12.5 million and it is estimated that by 2050 they will reach 51 million. This demographic transformation is accompanied by an increase in new cases of cancer in old age. According to AIOM/AIRC estimates, there will be about 400 thousand new diagnoses in Italy in 2024. AIRTUM data reveal how the incidence increases with age: from 750 cases per 100 thousand inhabitants in the 55-59 age group to more than 2,200 between the ages of 80 and 84. Some 70% of people diagnosed with cancer are over 70 years old, and one in five is over 80 years old. Yet this segment of the population is often excluded from clinical trials: in FDA-registered trials only 24% of participants are over 70 years old, and less than 10% are over 80 in NCI trials. In Italy, according to AIFA records, oncology patients treated in actual clinical practice are on average more than five years older than those included in clinical trials. The over-65s also account for 17% more.