Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA.
Department of Pediatrics, Prisma Health Children's Hospital, Greenville, SC, USA.
Sci Rep. 2022 Mar 9;12(1):3875. doi: 10.1038/s41598-022-07703-5.
Adolescent and young adult (AYA) enrollment in cancer clinical trials (CCT) is suboptimal. Few studies have explored site level barriers and facilitators to AYA enrollment on CCTs and the efficacy of interventions to enhance enrollment. A cross sectional survey was developed by the COG AYA Oncology Discipline Committee Responsible Investigator (RI) Network to identify perceived barriers and facilitators to enrollment, as well as opportunities to improve enrollment. Associations of barriers and facilitators to enrollment with program demographics were assessed. The survey was sent to all AYA RI Network members (n = 143) and quantitative and thematic analyses were conducted. The overall response rate was 42% (n = 60/143). Participants represented diverse institutions based on size, presence or absence of dedicated AYA programs, and proximity and relationship between pediatric and medical oncology practices within the institution. The most frequently cited barriers to enrolling AYAs in CCTs were administrative logistical issues (45%), disparate enrollment practices (42%) and communication issues (27%) between pediatric and medical oncology and perceived limited trial availability (27%). The most frequently reported facilitators to enrollment included having strong communication between pediatric and medical oncology (48%), having a supportive research infrastructure (35%) and the presence of AYA champions (33%). Many barriers and facilitators were similar across institutions and AYA program types. Shared barriers and facilitators to AYA CCT enrollment exist across the landscape of cancer care settings. Interventions aimed at increasing coordination between pediatric and medical oncology clinical trials offices and providers have high potential to improve site-level AYA enrollment.
青少年和年轻成人（AYA）在癌症临床试验（CCT）中的参与率不理想。很少有研究探讨过在 CCT 中招募 AYA 的现场障碍和促进因素，以及增强参与度的干预措施的效果。COG AYA 肿瘤学学科委员会负责调查员（RI）网络制定了一项横断面调查，以确定招募的感知障碍和促进因素，以及改善招募的机会。评估了与招募相关的障碍和促进因素与项目人口统计学之间的关联。该调查已发送给所有 AYA RI 网络成员（n=143），并进行了定量和主题分析。总体回复率为 42%（n=60/143）。参与者代表了不同规模的机构，存在或不存在专门的 AYA 计划，以及机构内儿科肿瘤学和医学肿瘤学实践之间的接近程度和关系。招募 AYA 参加 CCT 的最常被引用的障碍是行政后勤问题（45%）、不同的招募实践（42%）以及儿科肿瘤学和医学肿瘤学之间的沟通问题（27%），以及感知到的有限的试验可用性（27%）。报告最多的招募促进因素包括儿科肿瘤学和医学肿瘤学之间有强大的沟通（48%）、有支持性的研究基础设施（35%）和 AYA 拥护者的存在（33%）。许多障碍和促进因素在不同机构和 AYA 项目类型中都相似。在癌症治疗环境的各个领域都存在共享的 AYA CCT 招募障碍和促进因素。旨在增加儿科和医学肿瘤学临床试验办公室和提供者之间协调的干预措施具有很大的潜力，可以提高现场 AYA 的参与度。
