Elsevier

Seminars in Oncology

Volume 42, Issue 5, October 2015, Pages 740-747
Seminars in Oncology

Enhancing Adolescent and Young Adult Oncology Research Within the National Clinical Trials Network: Rationale, Progress, and Emerging Strategies

https://doi.org/10.1053/j.seminoncol.2015.07.012Get rights and content

Adolescent and Young Adult Oncology (AYAO, including patients 15–39 years of age) is an emerging discipline in the field of cancer treatment and research. Poorer survival outcomes for this population and characteristic age-related challenges in care have called attention to the need for increased AYAO research. This chapter outlines pressing questions and reviews recent progress in AYAO research within the current organizational structure of the federal clinical trials enterprise, emphasizing how the United States National Cancer Institute’s National Clinical Trials Network (NCTN) has created novel opportunities for collaborative AYAO research among the pediatric and adult NCTN groups. Potential strategies for expanding AYAO research, both within the NCTN and with other partners in the federal and advocacy domains are identified.

Section snippets

Rationale: Why Involvement of Adult Nctn Groups Is Essential for Aya Oncology

Confronting the AYAO population are several challenges that impede progress in improving survival. These include inferior geographic access to care,3 insurance,3 tolerance of therapy,4 and treatment adherence.5 There appear to be biological differences in some histologically similar malignancies presenting in pediatric, AYA, and older patients.6 In addition, there likely are substantial developmental differences in pharmacokinetics/pharmacodynamics that influence toxicity and efficacy.7

Critical

Aya Oncology and The Nctn: Recent Progress

The recent restructuring of the NCI-supported cooperative group trials network has significant potential to advance AYAO research. In March 2014, following recommendations from the Institute of Medicine,19 the nine previous adult cooperative groups were merged into four (NRG Oncology, Southwest Oncology Group [SWOG], Alliance Oncology, and Eastern Cooperative Oncology Group American College of Radiology Imaging Network [ECOG-ACRIN]). This reorganization helped form the NCI National Clinical

Strategies for Facilitating Ayao Research In The Nctn Groups

In addition to the federal initiatives noted above, internal cooperative group opportunities are available for enhancing AYA-focused research. In 2002, the COG became the first North American cooperative oncology group to develop a formal committee devoted to AYA oncology. The overall objective of the COG AYA Oncology Discipline Committee is to improve survival and quality of life for AYA patients through a greater understanding of differences in cancer and host biology, and their adjustment to

Conclusion

Due to the unique convergence of age, diseases, and characteristic clinical challenges, enhancing AYAO research requires deep integration of pediatric and medical oncology expertise. With creation of the NCTN, an unprecedented historical opportunity has arrived for achieving this. Individual NCTN groups have already spawned new studies, formed AYA committees, and launched other initiatives to increase AYAO research internally. The next frontier is AYA integration across the NCTN groups and

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    Financial disclosures and conflicts of interest: none declared.

    Supported in part by U10 CA180886 (ARW), U10 CA98543 (DRF), U10 CA180888 (CRN), and the Aflac Foundation (DRF).

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