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Teens miss out on clinical trials due to age limits

Report says trials must be more flexible

Jo Carlowe

Monday, 30 June 2014

Age limits on clinical trials need to be more flexible to allow more teenage cancer patients the chance to access new treatments.

This is the finding of a report from the National Cancer Research Institute (NCRI), published today in 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% rise in 15-19 year old cancer patients taking part in clinical trials between 2005 and 2010 (from 24 to 37%), and a 5% rise in 20-24 year olds (from 13 to 18 %). Children under 14 taking part in trials rose by 6% (from 52 to 58%).

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 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 added: “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 the Teenage Cancer Trust will be launching a 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.”

* Fern L A, Lewandowski J A, Coxon KM, Whelan J. Available, accessible, aware, appropriate, and acceptable: a strategy to improve participation of teenagers and young adults in cancer trials. The Lancet Oncology, Volume 15, Issue 8, Pages e341 - e350, July 2014 doi:10.1016/S1470-2045(14)70113-5

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