Forcina Victoria, Vakeesan Branavan, Paulo Chelsea, Mitchell Laura, Bell Jennifer Ah, Tam Seline, Wang Kate, Gupta Abha A, Lewin Jeremy
Adolescent and Young Adult Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
Joint Center for Bioethics, University of Toronto, Toronto, ON, Canada.
Adolesc Health Med Ther. 2018 Jun 13;9:87-94. doi: 10.2147/AHMT.S163121. eCollection 2018.
Although cancer clinical trials (CT) offer opportunities for novel treatments that may lead to improved outcomes, adolescents and young adults (AYA) are less likely to participate in these trials as compared to younger children and older adults. We aimed to identify the perceptions and attitudes toward CT in AYA that influence trial participation.
A systematic review of cancer literature was conducted that assessed perceptions and attitudes toward CT enrollment limited to AYA patients (defined as age 15-39). We estimated the frequency of identified themes by pooling identified studies.
In total, six original research articles were identified that specifically addressed perceptions or attitudes that influenced CT participation in AYA patients. Three studies were conducted at pediatric centers - one at an AYA unit, one at an adult cancer hospital, and one was registry based. Major themes identified for CT acceptability included: hope for positive clinical affect, altruism, and having autonomy. Potential deterrents included: prolonged hospitalization, worry of side effects, and discomfort with experimentation.
Limited information is available with regard to the perceptions and attitudes toward CT acceptability among AYA patients, especially those treated at adult cancer centers, which prevents generalization of data and themes. Future research assessing strategies for understanding and supporting CT decision-making processes among AYA represents a key focus for future funding to improve CT enrollment.
尽管癌症临床试验为可能带来更好治疗效果的新型疗法提供了机会，但与年幼儿童和老年人相比，青少年和青年（AYA）参与这些试验的可能性较小。我们旨在确定影响AYA参与试验的对癌症临床试验的看法和态度。
对癌症文献进行系统综述，评估仅限于AYA患者（定义为15 - 39岁）对参与癌症临床试验的看法和态度。我们通过汇总已确定的研究来估计已确定主题的出现频率。
总共确定了6篇原创研究文章，这些文章专门探讨了影响AYA患者参与癌症临床试验的看法或态度。3项研究在儿科中心进行——1项在AYA科室，1项在成人癌症医院，1项基于登记处。确定的癌症临床试验可接受性的主要主题包括：对积极临床效果的希望、利他主义和拥有自主权。潜在的阻碍因素包括：住院时间延长、对副作用的担忧以及对试验的不适。
关于AYA患者，尤其是在成人癌症中心接受治疗的患者对癌症临床试验可接受性的看法和态度，可用信息有限，这妨碍了数据和主题的推广。未来评估理解和支持AYA患者癌症临床试验决策过程策略的研究是未来资金投入以提高癌症临床试验入组率的关键重点。
