25 年来，青少年和年轻成年人参加美国国家癌症研究所资助的国家临床试验网络研究组的情况。
Adolescent and young adult enrollment to a National Cancer Institute-sponsored National Clinical Trials Network Research Group over 25 years.
机构信息
SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Mailman School of Public Health, Columbia University, New York, New York.
出版信息
Cancer. 2021 Dec 15;127(24):4574-4584. doi: 10.1002/cncr.33855. Epub 2021 Aug 5.
BACKGROUND
Adolescent and young adult (AYA) patients with cancer have not seen the same improvements in survival as younger (pediatric) patients and older patients (adults 40 years old or older). This may be related to their lower participation in clinical trials.
METHODS
This study examined AYA patient accrual to SWOG Cancer Research Network phase 1 to 3 clinical treatment trials for 29 cancers over 25 years (January 1996 to December 2020). Trial enrollments for AYA patients (15-39 years old) were compared with trial enrollments for older patients (40 years old or older) in SWOG and with US AYA cancer population rates derived from US Census and National Cancer Institute/Surveillance, Epidemiology, and End Results data.
RESULTS
In total, 84,219 patients were enrolled in SWOG treatment trials, including 7109 AYA patients (8.4%); in contrast, AYAs constituted 3.8% of the US cancer population. By histology, the highest proportions of AYA patients were in trials for Hodgkin disease (825 of 1220; 67.6%) and acute lymphocytic leukemia (350 of 678; 51.6%), whereas breast cancer trials had the greatest number of AYA patients (3032 of 32,693; 9.3%). SWOG AYA patients were more often female (68.8% vs 58.7%; P < .001), Black (10.1% vs 8.2%; P < .001), and Hispanic (10.6% vs 5.6%; P < .001) than SWOG patients who were 40 years old or older, and they were more often female (68.8% vs 65.1%; P < .001) but less often Black (10.1% vs 11.8%; P < .001) or Hispanic (10.6% vs 12.8%; P < .001) than AYA patients in the US cancer population.
CONCLUSIONS
AYA patients with cancer were well represented in SWOG clinical trials in comparison with US cancer population patients with the same cancers. The SWOG AYA population was more racially/ethnically diverse than older SWOG patients, although it was less diverse than the US AYA cancer population.
LAY SUMMARY
Adolescent and young adult (AYA) patients with cancer (aged 15-39 years) have not seen the same improvements in survival as younger (pediatric) patients and older patients (adults 40 years old or older). This may be related to their lower participation in clinical trials. This study evaluated the extent to which AYA patients were enrolled in a large, National Cancer Institute-sponsored network group over 25 years (1996-2020). Overall, 8.4% of the enrolled patients (7109 of 84,219) were AYAs; this was twice the corresponding rate of 3.8% in the US cancer population. AYA patients were also more racially/ethnically diverse than older trial patients, although they were less racially/ethnically diverse than the US AYA cancer population.
背景
青少年和年轻成人（AYA）癌症患者的生存率并未像年轻（儿科）患者和老年（40 岁及以上）患者那样得到同样的改善。这可能与他们参与临床试验的比例较低有关。
方法
本研究调查了 SWOG 癌症研究网络 29 种癌症的 1 期至 3 期临床治疗试验在 25 年内（1996 年 1 月至 2020 年 12 月）对 AYA 患者（15-39 岁）的入组情况。将 AYA 患者（15-39 岁）的试验入组与 SWOG 中年龄较大的患者（40 岁及以上）的试验入组进行比较，并与美国癌症人口普查和国家癌症研究所/监测、流行病学和最终结果数据中美国 AYA 癌症患者的比率进行比较。
结果
共有 84219 名患者参加了 SWOG 治疗试验，包括 7109 名 AYA 患者（8.4%）；相比之下，AYA 占美国癌症患者的 3.8%。按组织学分类，AYA 患者在霍奇金病（1220 例中有 825 例；67.6%）和急性淋巴细胞白血病（678 例中有 350 例；51.6%）试验中所占比例最高，而乳腺癌试验中 AYA 患者人数最多（32693 例中有 3032 例；9.3%）。SWOG AYA 患者中女性（68.8%比 58.7%；P<0.001）、黑人（10.1%比 8.2%；P<0.001）和西班牙裔（10.6%比 5.6%；P<0.001）的比例高于 40 岁及以上的 SWOG 患者，而女性（68.8%比 65.1%；P<0.001）的比例高于美国癌症患者，而黑人（10.1%比 11.8%；P<0.001）和西班牙裔（10.6%比 12.8%；P<0.001）的比例低于美国癌症患者。
结论
与具有相同癌症的美国癌症患者相比，SWOG 临床试验中 AYA 癌症患者的代表性良好。SWOG AYA 人群的种族/民族多样性比年龄较大的 SWOG 患者更为多样化，尽管与美国 AYA 癌症患者相比，其种族/民族多样性较低。
注：AYA 患者（adolescent and young adult）：青少年和年轻成人。
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