Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Increasing Access to Clinical Trials for Adolescents and Young Adults (AYA) with Cancer (#233)

Justine Ellis 1 2 , Anne Woollett 2 , Christie Allan 3 , Nicholas Ball 4 , Peter Choong 5 6 , Rachel Conyers 1 4 , Jordan Hansford 1 6 7 8 , Ryan Hehir 1 , Natasha Morello 2 , Sally O'Callaghan 9 , Lisa Orme 1 4 , Susan Sawyer 1 , Robyn Strong 10 , Leanne Super 1 11 , Angela Watt 12 , Chris Williams 1 13 , Jeremy Lewin 4 , Alexandra Robertson 1
  1. Royal Children's Hospital, Parkville, Vic
  2. Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
  3. Cancer Council Victoria, Melbourne
  4. ONTrac at PeterMac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne
  5. St Vincent's Hospital, Melbourne
  6. The University of Melbourne, Melbourne
  7. Murdoch Children's Research Institute, Parkville, Victoria
  8. Monash University, Clayton
  9. Orygen The National Centre of Excellence in Youth Mental Health, Melbourne
  10. Australina and New Zealand Children's Haematology/Oncology Group, Melbourne
  11. Monash Children's Hospital, Melbourne
  12. Melbourne Health, Melbourne
  13. Paediatric Integrated Cancer Services, Melbourne

Aims: International data demonstrate strong correlation between clinical trial participation and improved cancer survival. Adolescents and young adults (AYA) have low enrolment rates onto clinical trials and considerable international effort has worked to understand barriers to AYA trial access. In 2018, the Victorian Comprehensive Cancer Centre (VCCC) established a program of work to understand local barriers to AYA trial access, with the aim of developing targeted solutions that lead to greater AYA trial participation.

Methods: A steering committee (SC) was assembled, including expertise in adult and paediatric oncology, research ethics and governance, and consumer representation. The SC mapped Victorian barriers related to AYA trial access, and established Working Groups (WG) around three themes: Ethics and Governance, Access, and Availability. Each WG was tasked with identifying solutions to their assigned barriers.

Results: Identified ethics barriers for AYA trials in Victoria were found to be perceived. A guideline document was produced to raise awareness of current processes that support the approval of protocols with age eligibility ≤18>yrs. The Access WG identified the most significant barrier was young adult (18-25y) access to a paediatric hospital to enrol in a paediatric trial. A procedure has been written to streamline applications to Hospital Executive for young adult access (pending Executive approval). The Availability WG identified a lack of reciprocal relationships between paediatric and adult oncology as a key barrier to awareness of open trials, and to future research collaboration. An ‘AYA Craft Group’ Framework has been established to support growth of such relationships within relevant tumour streams across institutions.

Conclusions: A multi-pronged approach to improving AYA cancer clinical trial accrual has been developed. Although our program of work is Victorian based, the AYA trial equity issue should be on the national agenda, and we urge others to consider similar approaches in their local health environment.