A report from the National Cancer Research Institute (NCRI), published in the Lancet Oncology, says that age limits on clinical trials need to be more flexible to allow more teenage cancer patients the chance to access new treatments options. Under-representation of teenagers and young adults in clinical trials for cancer has been confirmed to be one of the primary reasons of the lower survival gains in this group of patients. The study, funded by the National Institute for Health Research and Teenage Cancer Trust, found that trials designed with broader age limits resulted in more teenagers and young adults going on clinical trials.
The results further showed that this recommendation led to a 13% rise in 15-19 year old cancer patients taking part in clinical trials between 2005 and 2010 (from 24% to 37%; ), and a 5% rise in 20-24 year olds (from 13% to 18%). Children under 14 taking part in trials rose by 6% (from 52% to 58%).
In total, the study included 68,275 patients aged 0-59 years, who were diagnosed with cancer between 1 April 2005 and 31 March 2010.
…patients often do better on trials due to the specialist care they receive… but right now too many of our young patients are needlessly falling through the gap between pediatric and adult cancer trials…
This rise was due to the increase in availability and access to trials for young people, increased awareness from healthcare professionals, patients and the public about research and importantly the opening of trials with broader age limits which allow older teenagers and young adults to enter trials.
Study leader Lorna Fern, PhD, Msc, University College London Hospitals NHS Foundation Trust, Department of Oncology, United Kingdom, who co-ordinates research for the NCRI Teenage and Young Adult Clinical Studies Group and is funded by Teenage Cancer Trust noted: “We know that patients often do better on trials due to the specialist care they receive. But right now too many of our young patients are needlessly falling through the gap between paediatric and adult cancer trials.”
“By encouraging doctors to take into account the full age range of patients affected by individual types of cancer, we’ve shown that it’s possible to design trials that include teenage cancer patients and, importantly, that better match the underlying biology of the disease and the people affected,” Fern said.
Based on the results of this study, Cancer Research UK is one of the first major cancer funders in the UK to start asking researchers to justify age restrictions on new studies, in an effort to recruit more teenage cancer patients onto its trials.
“Old or young, it’s vital that effective treatments are being developed to tackle cancer across all age brackets. We now only accept age limits on our clinical trials if they are backed up by hard evidence, which will hopefully mean more young cancer patients get the chance to contribute to research and have the latest experimental treatments,” said Kate Law, Cancer Research UK’s director of clinical trials.
Commenting on the study, Simon Fuller, director of services for Teenage Cancer Trust noted: “Too many young people miss out on clinical trials and we have been working with patients, politicians, the NCRI and other organisations to increase awareness of this lack of access. Changes are critical to improving the quality of life and chances of survival for young people with cancer aged 13 to 24. We need everyone involved in the commissioning and regulating of clinical trials to work together across the UK, Europe and internationally to help save young people’s lives. Next week we will be launching our own discussion paper at the 8th Teenage Cancer Trust International Conference on teenage and young adult cancer medicine.”
“These findings show that we’re gradually breaking down the barriers to allow more teenage and young adult patients to take part in cancer trials. If other cancer research funders adopt these recommendations then we have a great opportunity to help ensure more patients, both young and elderly, have access to treatments that could potentially benefit them,” Karen Kennedy, director of the NCRI, said.
For more information:
Fern LA, Lewandowski JA, Coxon KM, Whelan J. Available, accessible, aware, appropriate, and acceptable: a strategy to improve participation of teenagers and young adults in cancer trials. Lancet Oncol. 2014 Jul;15(8):e341-e350. doi: 10.1016/S1470-2045(14)70113-5. [Article][PubMed]
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