Managing teenage/young adult (TYA) brain tumors: a UK perspective

Abstract

Tumors of the CNS are among the commonest malignancies occurring in teenage/young adult patients (i.e., those aged between 15 and 24 years). The treatment of this patient population is challenging. Adolescence and young adulthood are a turbulent period of life, with physical, emotional, social and cognitive changes. Best practice advocates their treatment in dedicated teenage/young adult units, with multidisciplinary team input and access to clinical trials. Treatment of CNS malignancies is dependent upon histological subtype and staging, with varying combinations of surgery, radiotherapy and chemotherapy used. Clinical trials directly targeted at this patient population are rare; treatments are based on pediatric protocols as studies have demonstrated improved outcomes in patients (with other malignancies) treated as such. Scope for improvement lies in minimizing patient risk of recurrence and long-term sequelae of treatment. Molecular characterization of tumors may provide further information.

Racial/ethnic, socioeconomic, and geographic survival disparities in adolescents and young adults with primary central nervous system tumors

“…These papers, however, were focused on the adult neuro‐oncology population and have not emphasized the interplay between race/ethnicity, SES, and survival. Our differing findings are notable and could potentially be explained by unique AYA tumor biology or by more pronounced effects of previously described AYA challenges in the NHB population (i.e., social, psychological, adherence, as well as decreased clinical trial enrollment) 3–6,33,34 …”

“…Our differing findings are notable and could potentially be explained by unique AYA tumor biology or by more pronounced effects of previously described AYA challenges in the NHB population (i.e., social, psychological, adherence, as well as decreased clinical trial enrollment). [3][4][5][6]33,34 The findings above highlight the need for further research to assess and address the role of other covariates in these survival disparities. Social determinants of health such as food insecurity, housing instability, ability to pay for utilities, and personal safety issues have been shown to negatively impact both therapy adherence and…”

Recent Emerging Immunological Treatments for Primary Brain Tumors: Focus on Chemokine-Targeting Immunotherapies

“…Each of these therapeutic options provides its fundamental contribution to a positive prognosis. In fact, in the treatment of neoplastic pathology, the trimodal therapeutic approach considerably increases the possibility of healing and reduces the risk of relapses [ 26 ].…”

The Molecular Landscape of Medulloblastoma in Teenagers and Young Adults

“…TYAs present with a spectrum of cancers distinct from children and older adults. More than any other malignancies, central nervous system (CNS) tumours demand a focused approach in TYAs because of their complexity and prognosis [ 6 ]. Even benign primary CNS tumours can be life-threatening because of their brain-damaging effects, local infiltration, and for some, a tendency to undergo malignant transformation over time.…”