Children's Oncology Group 2023 blueprint for research: Adolescent and young adult oncology

Abstract

Over the past few decades, 5‐year cancer survival has steadily improved for all adolescents and young adults (AYA, 15–39 years at diagnosis) combined. While encouraging, this progress simultaneously highlights a compelling need for improving survival in higher risk AYA subsets and for addressing health outcomes and health‐related quality of life (HRQoL) among long‐term survivors. The Children's Oncology Group (COG), in collaboration with the National Cancer Institute (NCI) and the adult network groups within the NCI National Clinical Trials Network (NCTN), has developed a large and growing portfolio of therapeutic AYA cancer clinical trials to identify optimal treatment approaches for common AYA cancers. Additional initiatives, led by the COG AYA Oncology Discipline Committee for increasing collaboration between the COG and the adult network groups, optimizing AYA clinical trial enrollment, and standardizing the assessment of HRQoL, have been highly successful to date. Further, NCTN‐wide collaborations are currently underway focused on improving survival for AYA malignancies with poor prognosis and, through development of supportive care and care delivery trials, reducing the short‐ and long‐term toxicity caused by cancer treatment. Leveraging the research infrastructure within the NCTN and the NCI Community Oncology Research Program, the COG will continue to champion meaningful advancements in health and survival for AYAs with cancer.

Alliance A151945: Accrual and characteristics of adolescent and young adult patients in Alliance trials from 2000 to 2017

“…This is a recognized gap, and efforts are underway across the NCTN and the NCI Community Oncology Research Program (NCORP) to promote development of supportive care trials for AYAs. 30 Our analysis has several limitations. As noted above, we chose to restrict the current analysis to closed CALGB/ACOSOG/NCCTG/ Alliance-sponsored trials, excluding ongoing trials, which resulted in an underestimate of actual annual accrual in more recent years.…”

“…Identifying systems-level barriers to enrollment is critical to implementing strategies to improve AYA accrual at the site level. Ongoing initiatives to address some of these barriers include the Children's Oncology Group (COG) AYA Responsible Investigator Network, an effort to promote AYA trial enrollment that includes designating champions at study sites,30 and the revitalization of the NCTN-NCORP AYA Working Group, which was formed to bring key stakeholders from the NCI and cooperative groups to foster an AYAfocused research agenda. Results from our study, in combination with the recent SWOG analyses, indicate that AYA representation in NCTN clinical trials is aligned with or exceeds population prevalence estimates for most cancer types.…”