Proceedings of a workshop

Bleyer, Archie; Morgan, Sue; Barr, Ronald D.

doi:10.1002/cncr.22104

Cited by 41 publications

(5 citation statements)

References 85 publications

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“…The age range for definition of AYA patients with malignancies is highly variable and has been in flux as more awareness develops in this unique field [7,9,10]. Various age ranges have been proposed, such as ages between 12 and 24 years [11] or between 15 and 25 [11], or 15 and 29 [5,12].…”

Section: Definition Of Ayamentioning

confidence: 99%

Chronic Myeloid Leukemia in Adolescents and Young Adults: Patient Characteristics, Outcomes and Review of the Literature

Pemmaraju

Cortés

2014

Acta Haematol

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Over the past two decades, many improvements have been made in the management of patients with leukemia. Research in this field most often focuses on the youngest and oldest patient age groups. However, the population of patients in between those age groups has received relatively little attention with few studies specifically focusing on them. This important ‘age gap' has demonstrated a unique, difficult-to-treat group of patients known as adolescents and young adults, or AYAs. Variably defined in the literature as patients from late teenage years to the age of up to 40 years, the AYA group of patients represents a vulnerable subset of patients now identified to require its own focus, development of therapeutic strategies and parallel emphasis on special support systems involving multidisciplinary psychosocial care. Despite the great advancements that have been realized for patients with chronic myeloid leukemia (CML), the AYA group has seldom been the focus of specific reports and studies, and the outcome appears to lag behind the general population. This review focuses on this subset of AYA patients with CML and summarizes the available data and recent developments, challenges and treatment options for this group of patients.

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Section: Definition Of Ayamentioning

confidence: 99%

Chronic Myeloid Leukemia in Adolescents and Young Adults: Patient Characteristics, Outcomes and Review of the Literature

Pemmaraju

Cortés

2014

Acta Haematol

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“…The logistic concerns include the location of care for the adolescent patients and require increased cooperation between pediatric and medical oncologists (and their respective institutions) who may not be in the same geographic location (5, 21, 22). Revising age eligibility criteria would also allow for the enrollment of adolescents on relevant clinical trials when they are managed outside of a pediatric setting.…”

Section: Potential Barriersmentioning

confidence: 99%

“…Lack of access to relevant trials for adolescents, either in the up-front or relapsed setting, is often cited as one reason for this discrepancy (5). Much of the more than 50% decrease in overall childhood cancer mortality since 1975 has been attributed to clinical trial participation, but survival improvements for adolescents and young adults have historically lagged behind the pediatric population as a whole, and decreased participation in clinical trials may contribute to this finding (6, 7).…”

Section: Introductionmentioning

confidence: 99%

Enrolling Adolescents in Disease/Target-Appropriate Adult Oncology Clinical Trials of Investigational Agents

Chuk

Mulugeta

Roth-Cline

et al. 2017

Clinical Cancer Research

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The enrollment of adolescents with cancer in clinical trials is much lower than younger pediatric patients. For adolescents with “adult-type” cancers, lack of access to relevant trials is cited as one of the reasons for this discrepancy. Adolescents are generally not eligible for enrollment on adult oncology trials, and initial pediatric trials for many drugs are conducted years later, often after the drug is approved. As a result, accrual of adolescents to these trials may be slow due to off-label use, prospectively collected safety and efficacy data is lacking at the time of initial approval, and, most importantly, these adolescents have delayed access to effective therapies. In order to facilitate earlier access to investigational and approved drugs for adolescent patients with cancer, and because drug exposure is most often similar in adolescents and adults, we recommend the inclusion of adolescents (ages 12-17) on disease and target-appropriate adult oncology trials. This approach requires careful monitoring for any differential safety signals, appropriate pharmacokinetic evaluations, and ensuring that ethical requirements are met. Inclusion of adolescents on adult oncology trials will require the cooperation of investigators, cooperative groups, industry, IRBs, and regulatory agencies to overcome real and perceived barriers.

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“…Despite all of the differences between children and AYA patients, and between adults and AYA patients, historically, AYA patients are usually merged in clinical trials with either children (1–18 years), or adults (>16 years). The overall treatment outcomes are worse in AYA patients than in the pediatric population, and the AYA group is underrepresented in clinical trials 13,14. Among the proposed explanations for this observation is that these patients are being treated by either adult or pediatric oncologists, who may vary in their familiarity/unfamiliarity with studies in the “other” field; alternatively, there may be differences in biology (some tumors may respond better to adult protocols, while some may respond better on pediatric protocols).…”

Section: Definition and Demographics Of Stssmentioning

confidence: 99%

Targeted therapy for soft tissue sarcomas in adolescents and young adults

Steppan

Pratilas

Loeb

2017

AHMT

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Soft tissue sarcomas (STSs) are a heterogeneous group of tumors originating from the mesenchyme. Even though they affect individuals in all age groups, the prevalence of subtypes of STSs changes significantly from childhood through adolescence into adulthood. The mainstay of therapy is surgery, with or without the addition of chemotherapy and/or radiation therapy. These treatment modalities are associated, in many cases, with significant morbidity and, given the heterogeneity of tumor histologies encompassed by the term “STS”, have not uniformly improved outcomes. Moreover, some subgroups of STSs appear to be more, and others less, responsive to conventional chemotherapy agents. Over the last two decades, our understanding of the biology of STSs is slowly increasing, allowing for the development of more targeted therapies. We review the new treatment modalities that have been tested on patients with STSs, with a special focus on adolescents and young adults, a group of patients that is often underrepresented in clinical trials and has not received the dedicated attention it deserves, given the significant differences in biology and treatment response in comparison to children and adults.

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Proceedings of a workshop

Cited by 41 publications

References 85 publications

Chronic Myeloid Leukemia in Adolescents and Young Adults: Patient Characteristics, Outcomes and Review of the Literature

Chronic Myeloid Leukemia in Adolescents and Young Adults: Patient Characteristics, Outcomes and Review of the Literature

Enrolling Adolescents in Disease/Target-Appropriate Adult Oncology Clinical Trials of Investigational Agents

Targeted therapy for soft tissue sarcomas in adolescents and young adults

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