The AYA gap for rhabdomyosarcoma

Abstract

Cancer is the leading cause of death among adolescents and young adults (AYAs). Cancers diagnosed during the AYA period-defined by the National Cancer Institute as the age from 15 to 39 years-account for approximately 5% of all cancers. 1 As per the national report on the status of cancer (study period 2015-2019, 1 ), 5-year relative survival rates for both children and AYAs suffering from cancer are high (85.1% for children and 85.8% for AYAs), and improvements in survival over time appear to be similar for both age groups. 1 Yet, the spectrum of cancer types diagnosed in AYAs varies widely. The most common malignancies are female breast cancer (15%), thyroid cancer (15%), testicular cancer (8%), and melanomas (7%), 1 but AYAs may also suffer from so-called pediatric cancers with peak incidence during childhood. When compared to their childhood counterparts, worse outcomes were reported for AYAs diagnosed with pediatric cancers, including but not limited to leukemias 2 and sarcomas. 3 This "AYA gap" is of concern to both pediatric and adult oncologists. The accompanying paper by Harrison et al. examines a cohort of 2151 patients with rhabdomyosarcomas (RMS) enrolled in consecutiveChildren's Oncology Group (COG) trials, including 19% AYAs aged 15-39 years and 81% children aged 0-14 years. 4 Compared to children with RMS, AYAs experienced significantly lower 5-year event-free survival (EFS; 44% vs. 67%) and 5-year overall survival (OS; 52% vs. 78%).