Jacob Seethal A, Shaw Peter H
Division of Hematology/Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
Pediatr Blood Cancer. 2017 Dec;64(12). doi: 10.1002/pbc.26638. Epub 2017 May 16.
We have previously published data from 2001 to 2006 showing that adolescent and young adult (AYA) oncology patients have significantly lower therapeutic clinical trial enrollment rates than younger patients. Our objective was to determine if the enrollment of AYA patients on therapeutic studies at the same institution has improved in recent years with the greater focus on this population locally and nationally.
We retrospectively analyzed cancer registry data at the Children's Hospital of Pittsburgh (CHP) for all new oncologic diagnoses between January 2010 and December 2014. These data included age, gender, diagnosis, race and whether the patient was enrolled on an open treatment study. Univariate analyses were carried out to compare demographic data between AYA patients (aged 15-22) who enrolled on study and those who did not.
Eight hundred sixty-five new oncology patients were seen at CHP during this time, 23% of whom were 15 years or older; 33% of all patients were treated on a clinical trial, including 34% of younger patients and 24% of older patients (P = 0.0017). The differences between these rates and those from prior years in both age groups (38% and 27%, respectively) were not statistically significant (P = 0.15, 0.53). The most common reason for the low enrollment rates was again the lack of an open therapeutic trial.
Despite initiatives at CHP and on the national level to enroll more AYA patients on clinical trials, our most recent data show no improvement. This is a potentially remediable factor that needs to continue to be prioritized nationally.
我们之前发表了2001年至2006年的数据，表明青少年和青年（AYA）肿瘤患者的治疗性临床试验入组率显著低于年龄更小的患者。我们的目标是确定近年来，在同一机构进行的治疗性研究中，AYA患者的入组情况是否有所改善，因为本地和全国范围内对这一人群的关注有所增加。
我们回顾性分析了匹兹堡儿童医院（CHP）2010年1月至2014年12月期间所有新确诊肿瘤患者的癌症登记数据。这些数据包括年龄、性别、诊断结果、种族以及患者是否参加了开放治疗研究。进行单因素分析以比较参加研究的AYA患者（年龄15 - 22岁）和未参加研究的患者之间的人口统计学数据。
在此期间，CHP共诊治了865名新肿瘤患者，其中23%的患者年龄在15岁及以上；所有患者中有33%接受了临床试验治疗，其中年龄较小的患者为34%，年龄较大的患者为24%（P = 0.0017）。这两个年龄组的这些比率与前几年的比率（分别为38%和27%）之间的差异无统计学意义（P = 0.15，0.53）。入组率低的最常见原因再次是缺乏开放的治疗性试验。
尽管CHP和国家层面都采取了措施，以使更多AYA患者参加临床试验，但我们的最新数据显示情况并未改善。这是一个可能可补救的因素，需要在全国范围内继续作为优先事项。
