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Cancer. 2015 Dec 15;121(24):4398-406. doi: 10.1002/cncr.29669. Epub 2015 Sep 22.

Case-linked analysis of clinical trial enrollment among adolescents and young adults at a National Cancer Institute-designated comprehensive cancer center.

Author information

1
Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California.
2
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.
3
Los Angeles Cancer Surveillance Program, University of Southern California Keck School of Medicine, Los Angeles, California.
4
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California.
5
Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California.

Abstract

BACKGROUND:

Poor accrual to cancer clinical trials may contribute to the lower improvement in survival observed for adolescents and young adults (AYAs) (those aged 15-39 years) with cancer. This has been difficult to quantify without reliable mechanisms to link incident cases with study enrollments. Using unique resources available at their National Cancer Institute-designated comprehensive cancer center, the authors compared the percentage of AYAs, children, and older adults enrolled onto cancer clinical trials and determined predictors of enrollment.

METHODS:

Patients diagnosed with cancer from January 2008 through December 2012 at 1 pediatric and 2 adult University of Southern California hospitals were identified through the California Cancer Registry and individually linked to institutional trial enrollment databases. The availability of clinical trials was assessed.

RESULTS:

Across the center, the enrollment percentage for AYAs (6%) was equal to that of older adults (6%), but was less than that for children (22%) (P < .01). Within the children's hospital, the AYA enrollment percentage was also less than that for children (15% vs 23%, respectively; P<.01). On multivariate analysis, diagnosis and site of care were found to be predictive of AYA enrollment onto therapeutic and nontherapeutic studies. Hispanic and Asian/Pacific Islander individuals were more likely to enroll onto nontherapeutic studies compared with non-Hispanic whites, but no racial/ethnic difference was observed for therapeutic studies.

CONCLUSIONS:

In the current study, the percentages of AYAs and older adults enrolled onto therapeutic trials were low but similar. Diagnosis, site of care, and race/ethnicity appear to be predictive of enrollment. Prospective mechanisms must be instituted to capture reasons for nonenrollment of AYAs and develop corrective interventions.

KEYWORDS:

adolescent; clinical oncology; clinical trial as topic; young adult

PMID:
26393950
DOI:
10.1002/cncr.29669
[Indexed for MEDLINE]
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