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. 2015 Jun;3(2):137-145.
doi: 10.1007/s40124-015-0075-y. Epub 2015 Feb 18.

The Clinical Trials Gap for Adolescents and Young Adults with Cancer: Recent Progress and Conceptual Framework for Continued Research

David R Freyer  1 , Nita L Seibel  2
Affiliations

The Clinical Trials Gap for Adolescents and Young Adults with Cancer: Recent Progress and Conceptual Framework for Continued Research

David R Freyer et al. Curr Pediatr Rep. 2015 Jun.

Abstract

Over the past 30 years, adolescents and young adults (AYA, 15-39 years of age) with cancer have shown significantly less improvement in survival than younger and older patients. Because evidence suggests this may be related to their low participation in cancer clinical trials, increasing accrual to these trials has become a priority for closing this "AYA gap." This paper reviews data documenting low AYA enrollment, presents a conceptual framework for research and intervention (Clinical Trials Pathway to Enrollment) and summarizes recent developments in the United States National Cancer Institute-sponsored clinical trials enterprise that are expected to improve AYA enrollment, including the National Clinical Trials Network (NCTN) and expanded scientific collaboration between the Children's Oncology Group and adult NCTN groups. While time will be required for the effects of these changes to be fully realized, they offer a mechanism for facilitating the breadth of clinical/translational research needed for advancing AYA oncology and measuring its impact.

Keywords: AYA gap; Adolescent and young adult (AYA); Clinical trials; Clinical trials accrual; Clinical trials enrollment; National Clinical Trials Network (NCTN).

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Conflict of interest statement

Disclosure The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The Clinical Trials Pathway to Enrollment. Successful enrollment of an AYA patient onto a cancer clinical trial is not a single event but the culmination of several steps requiring availability, accessibility, presentation, and acceptance of the clinical trial. All steps involve a question that must be answered “yes” in order to result in successful enrollment of the patient; an answer of “no” to any question is enough to prevent enrollment. This pathway serves as a conceptual framework for developing targeted interventions to reduce barriers and increase enrollment of AYAs to cancer clinical trials
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