Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE)

A Ferrari¹, D Stark², F A Peccatori³, L Fern⁴, V Laurence⁵, N Gaspar⁶, I Bozovic-Spasojevic⁷, O Smith⁸, J De Munter⁹, K Derwich¹⁰, L Hjorth¹¹, W T A van der Graaf¹², L Soanes¹³, S Jezdic¹⁴, A Blondeel¹⁵, S Bielack¹⁶, J-Y Douillard¹⁴, G Mountzios¹⁷, E Saloustros¹⁸

Affiliations

¹ Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: education@esmo.orgss.
² Leeds Institute of Medical Research, School of Medicine University of Leeds, Leeds, UK. Electronic address: education@esmo.orgsss.
³ Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy.
⁴ Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
⁵ Medical Oncology Department and SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, Paris, France.
⁶ Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France.
⁷ Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia.
⁸ National Children's Cancer Service, Children's Health Ireland at Crumlin and Systems Biology Ireland, University College Dublin, Dublin, Ireland.
⁹ University Hospital Ghent Cancer Center, UZ Gent, Ghent, Belgium.
¹⁰ Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
¹¹ Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Pediatrics, Lund, Sweden.
¹² Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
¹³ Teenage Cancer Trust, London, UK.
¹⁴ Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland.
¹⁵ Department of Scientific Programme Coordination, European Society for Paediatric Oncology (SIOPE), Brussels, Belgium.
¹⁶ Zentrum für Kinder, Jugend und Frauenmedizin Pädiatrie 5, KlinikumStuttgart - Olgahospital, Stuttgart, Germany.
¹⁷ 2nd Department of Medical Oncology and Clinical Trial Unit, Henry Dunant Hospital, Athens, Greece.
¹⁸ Department of Oncology, University Hospital of Larissa, Larissa, Greece.

PMID: 33926710
PMCID: PMC8103533
DOI: 10.1016/j.esmoop.2021.100096

Review

Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE)

A Ferrari et al. ESMO Open. 2021 Apr.

. 2021 Apr;6(2):100096.

doi: 10.1016/j.esmoop.2021.100096.

Authors

Affiliations

¹ Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: education@esmo.orgss.
² Leeds Institute of Medical Research, School of Medicine University of Leeds, Leeds, UK. Electronic address: education@esmo.orgsss.
³ Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy.
⁴ Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
⁵ Medical Oncology Department and SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, Paris, France.
⁶ Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France.
⁷ Medical Oncology Department, Institute for Oncology and Radiology of Serbia, Belgrade, Republic of Serbia.
⁸ National Children's Cancer Service, Children's Health Ireland at Crumlin and Systems Biology Ireland, University College Dublin, Dublin, Ireland.
⁹ University Hospital Ghent Cancer Center, UZ Gent, Ghent, Belgium.
¹⁰ Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
¹¹ Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Pediatrics, Lund, Sweden.
¹² Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
¹³ Teenage Cancer Trust, London, UK.
¹⁴ Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland.
¹⁵ Department of Scientific Programme Coordination, European Society for Paediatric Oncology (SIOPE), Brussels, Belgium.
¹⁶ Zentrum für Kinder, Jugend und Frauenmedizin Pädiatrie 5, KlinikumStuttgart - Olgahospital, Stuttgart, Germany.
¹⁷ 2nd Department of Medical Oncology and Clinical Trial Unit, Henry Dunant Hospital, Athens, Greece.
¹⁸ Department of Oncology, University Hospital of Larissa, Larissa, Greece.

PMID: 33926710
PMCID: PMC8103533
DOI: 10.1016/j.esmoop.2021.100096

Abstract

It is well recognised that adolescents and young adults (AYA) with cancer have inequitable access to oncology services that provide expert cancer care and consider their unique needs. Subsequently, survival gains in this patient population have improved only modestly compared with older adults and children with cancer. In 2015, the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE) established the joint Cancer in AYA Working Group in order to increase awareness among adult and paediatric oncology communities, enhance knowledge on specific issues in AYA and ultimately improve the standard of care for AYA with cancer across Europe. This manuscript reflects the position of this working group regarding current AYA cancer care, the challenges to be addressed and possible solutions. Key challenges include the lack of specific biological understanding of AYA cancers, the lack of access to specialised centres with age-appropriate multidisciplinary care and the lack of available clinical trials with novel therapeutics. Key recommendations include diversifying interprofessional cooperation in AYA care and specific measures to improve trial accrual, including centralising care where that is the best means to achieve trial accrual. This defines a common vision that can lead to improved outcomes for AYA with cancer in Europe.

Keywords: adolescents and young adults; cancer; clinical trials; education; interdisciplinary.

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Conflict of interest statement

Funding The European Society for Medical Oncology (ESMO) (no grant number) and the European Society for Paediatric Oncology (SIOPE) (no grant number) were the legal sponsors of this position paper. No research funding for the meetings or manuscript preparation was received from any third parties. Disclosure DS reports receipt of research grants from Teenage Cancer Trust. FAP reports personal financial interest as a Scientific Director at the European School of Oncology; receipt of lecture/presentation fees from Prime Oncology and Takeda; receipt of honoraria for advisory board participation/advisory services from Roche, AstraZeneca, Clovis and Ipsen. LF reports receipt of funding from Teenage Cancer Trust. IB-S reports receipt of speaker fees from Roche, Novartis and Pfizer; direct research funding as Principal Investigator from Roche; financial support to institution for clinical trials from Roche. OS reports receipt of honoraria for advisory board participation from Genuity Science. LH reports receipt of speaker fees from Roche. WTAvdG reports receipt of research funding from Novartis, honoraria for advisory board from Bayer and consultancy fees from SpringWorks, all to her institutes. SB reports receipt of honoraria for advisory board participation from Pfizer, Bayer, Lilly, Novartis and Isofol. GM reports receipt of speakers fees from AstraZeneca, Roche, MSD, BMS, Pfizer, Takeda, Janssen, Novartis and Sanofi; receipt of consultancy fees from AstraZeneca, Roche, MSD, BMS, Novartis and Sanofi; direct research funding as Principal Investigator from AstraZeneca, Novartis and MSD; financial support to institution for clinical trials from AstraZeneca, Novartis and MSD. ES reports receipt of honoraria for the provision of advisory services from Roche Hellas, BMS, Pfizer Hellas, AstraZeneca, Amgen Hellas and Dimiourgiki Farmakeutikon Ypiresion AE; receipt of research funding from Astellas Pharma; travel and education support from Roche Hellas, Pfizer Hellas, Astellas Pharma, Novartis (Hellas), MSD Greece and Enorasis. All other authors have declared no conflicts of interest.

Figures

**Figure 1**
The percentage distribution of AYA cancers (excluding *in situ*) illustrated by age group (US Surveillance, Epidemiology and End Results Program 18 areas, 2004-2017). The Authors thank Ronald Barr, Lynn Ries, Annalisa Trama, Gemma Gatta, Eva Steliarova-Foucher, Charles Stiller and Archie Bleyer, as well as Alice Bernasconi, who provided this figure for use in the current manuscript. AYA, adolescents and young adults; CNS, central nervous system.

See this image and copyright information in PMC

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Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE)

Affiliations

Adolescents and young adults (AYA) with cancer: a position paper from the AYA Working Group of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE)

Authors

Affiliations

Abstract

Conflict of interest statement

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