Concern at lack of teenage patients in cancer trials

Age limits on clinical trials need to be more flexible to allow more teenage cancer patients the chance to access new treatments, according to a report from the National Cancer Research Institute (NCRI), published in the Lancet Oncology.

The study, funded by the National Institute for Health Research and Teenage Cancer Trust, found that trials designed with broader age limits resulted in more teenagers and young adults going on clinical trials.

The study showed this recommendation led to a 13 per cent rise in 15-19 year old cancer patients taking part in clinical trials between 2005 and 2010 (from 24 to 37 per cent), and a five per cent rise in 20-24 year olds (from 13 to 18 per cent). Children under 14 taking part in trials rose by six per cent (from 52 to 58 per cent)*.

This rise was due to the increase in availability and access to trials for young people, increased awareness from healthcare professionals, patients and the public about research and importantly the opening of trials with broader age limits which allow older teenagers and young adults to enter trials.

Study leader Dr Lorna Fern, who co-ordinates research for the NCRI Teenage and Young Adult Clinical Studies Group and is funded by Teenage Cancer Trust said: "We know that patients often do better on trials due to the specialist care they receive. But right now too many of our young patients are needlessly falling through the gap between paediatric and adult cancer trials.

"By encouraging doctors to take into account the full age range of patients affected by individual types of cancer, we've shown that it's possible to design trials that include teenage cancer patients and, importantly, that better match the underlying biology of the disease and the people affected."

In light of this study, Cancer Research UK is one of the first major cancer funders in the UK to start asking researchers to justify age restrictions on new studies, in an effort to recruit more teenage cancer patients onto its trials.

Kate Law, Cancer Research UK's director of clinical trials, said: "Old or young, it's vital that effective treatments are being developed to tackle cancer across all age brackets. We now only accept age limits on our clinical trials if they are backed up by hard evidence, which will hopefully mean more young cancer patients get the chance to contribute to research and have the latest experimental treatments."

Simon Fuller, director of services for Teenage Cancer Trust comments: "Too many young people miss out on clinical trials and we have been working with patients, politicians, the NCRI and other organisations to increase awareness of this lack of access. Changes are critical to improving the quality of life and chances of survival for young people with cancer aged 13 to 24. We need everyone involved in the commissioning and regulating of clinical trials to work together across the UK, Europe and internationally to help save young people's lives. Next week we will be launching our own discussion paper at the 8th Teenage Cancer Trust International Conference on teenage and young adult cancer medicine."

Dr Karen Kennedy, director of the NCRI, said: "These findings show that we're gradually breaking down the barriers to allow more teenage and young adult patients to take part in cancer trials. If other cancer research funders adopt these recommendations then we have a great opportunity to help ensure more patients, both young and elderly, have access to treatments that could potentially benefit them."

For media enquiries please contact the NCRI press office on 020 3469 8300 or, out-of-hours, the duty press officer on 07050 264 059.

Fern L. et al. Available, accessible, aware, appropriate and acceptable: a strategy to improve participation of teenagers and young adults in cancer trials, Lancet Oncology (2014)

*The study looked at 68,275 patients aged 0-59 years, who were diagnosed with cancer between 1 April 2005 and 31 March 2010. During this six year period, trial participation among 15-19 year olds increased from 116\481 individuals (24 per cent) to 184\492 (37 per cent) and among 20-24 year olds from 88\653 individuals (13 per cent) to 129\713 individuals (18 per cent). Participation among 0-14 year olds increased from 518\1005 individuals (52 per cent) to 594\1025 individuals (58 per cent).