Improved collaboration and clinical trial enrollment in adolescent and young adult (AYA) oncology patients after the establishment of an AYA program.

Abstract

9558 Background: Over the past thirty years there has been significant improvement in the survival rates of pediatric and older cancer patients, but adolescent and young adult (AYA) patients aged 15-40 years old have not seen the same improvement. The reasons are multifactorial but data has shown a direct correlation between improving cure rates and clinical trial enrollment. We have published data showing inferior clinical trial enrollment when these patients are treated at an adult versus an affilaited pediatric oncology center. To address this deficit, we at the Children's Hospital of Pittsburgh (CHP) and University of Pittsburgh Cancer Institute (UPCI) established a joint AYA Oncology Program. The primary goal of this program was and is to improve outcomes by increasing clinical trial accrual in this population. Methods: We retrospectively analyzed patients referred to our AYA program from July, 2006 through December, 2009 to establish if referrals were improving and clinical trial enrollment was increasing versus historical controls from 2003-2006 at the same institutions. Patients outside of the AYA age range could be evaluated if they were diagnosed with a malignancy more common in this age group. Results: 46 patients were referred to our program from 9 different hospitals. In the year prior to program (2005), only 2 patients were referred which increased to 15 in 2006, followed by 11 in 2007, 13 in 2008 and 14 projected for 2009. The median age of all patients evaluated was 22 years-old (range 13-75 years). 18 of these patients were treated or followed at CHP with 5 (27%) enrolled on a clinical trial. 21 were treated at the UPCI with 5 (24%) on a clinical trial. There was no difference in enrollment rates in those patients treated at CHP after the program was established but there was superior trial participation compared to the previous three years at the UPCI (p<0.001). Conclusions: Our data demonstrate that establishing a unified AYA Oncology Program both leads to increased referrals and improved clinical trial enrollment in this population. It is too soon to conclude if more trial participation for these patients will translate into improved disease-free survival. No significant financial relationships to disclose.