Use of Communication Technology to Improve Clinical Trial Participation in Adolescents and Young Adults With Cancer: Consensus Statement From the Children's Oncology Group Adolescent and Young Adult Responsible Investigator Network

Abstract

Adolescents and young adults (AYAs; age 15-39 years) with cancer are under-represented in cancer clinical trials because of patient, provider, and institutional barriers. Health care technology is increasingly available to and highly used among AYAs and has the potential to improve cancer care delivery. The COVID-19 pandemic forced institutions to rapidly adopt novel approaches for enrollment and monitoring of patients on cancer clinical trials, many of which have the potential for improving AYA trial participation overall. This consensus statement from the Children's Oncology Group AYA Oncology Discipline Committee reviews opportunities to use technology to optimize AYA trial enrollment and study conduct, as well as considerations for widespread implementation of these practices. The use of remote patient eligibility screening, electronic informed consent, virtual tumor boards, remote study visits, and remote patient monitoring are recommended to increase AYA access to trials and decrease the burden of participation. Widespread adoption of these strategies will require new policies focusing on reimbursement for telehealth, license portability, facile communication between electronic health record systems and advanced safeguards to maintain patient privacy and security. Studies are needed to determine optimal approaches to further incorporate technology at every stage of the clinical trial process, from enrollment through study completion.

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

“…The network has identified additional accrual barriers through regular webinars and workshops, has developed a Frequently Asked Questions document addressing common questions and misconceptions on how to cross-enroll AYAs onto NCTN trials, and developed novel strategies leveraging communication technology to further improve enrollment. 36,37 The COG AYA RI Network will continue to foster site-level participation in newly developed NCTN and NCORP AYA trials via regular webinars for presentations by study chairs. Newer approaches to improve accrual are under investigation, including a multisite quality improvement initiative known as ATAQI (AYA Trial Access Quality Initiative).…”

“…The AYA RI Network now includes local site AYA champions, including pediatric and medical oncology providers, from more than 120 institutions working together to boost local AYA clinical trial enrollment. The network has identified additional accrual barriers through regular webinars and workshops, has developed a Frequently Asked Questions document addressing common questions and misconceptions on how to cross‐enroll AYAs onto NCTN trials, and developed novel strategies leveraging communication technology to further improve enrollment 36,37 …”