AYA Oncology Comes of Age

Since that first and famous NCI progress review group was formed, we now have dedicated providers for this patient population, specialty journals and conferences, and a professional organization. There are a slew of AYA advocacy groups – including Critical Mass, Stupid Cancer, LIVESTRONG, Up Cancer, Young Survival Coalition, and Teen Cancer America. The patients themselves are speaking out on social media, as well as lobbying Congress about the unique needs of adolescent and young adult cancer patients and survivors.
 
This is all gaining significant traction. Last year, AYA activists succeeded in introducing a bill in the U.S. House of Representatives that would allow for student loan deferments while borrowers undergo cancer treatment. Also, last year, as part of their recommendations to broaden eligibility requirements for cancer clinical trials, ASCO and Friends of Cancer Research recommended including children younger than age 18 years on adult trials. Officials at the U.S. Food and Drug Administration are discussing this possibility as we speak.
 
Here at SWOG, AYA oncology is also of major importance. Back in 2013, we created the first AYA group in the adult NCTN. Drs. Mark Lewis and Becky Johnson now run our AYA committee, with Becky forging stronger ties to our NCTN colleagues in Children’s Oncology Group and Mark working on a plan to consistently connect with our SWOG disease committees. An incredibly important biomarker-driven testes cancer trial proposal, S1823, has already come out of this committee, in conjunction with COG.
 
S1823 will follow 1,150 post-treatment patients with stage 1 testicular germ cell tumors. As you all know, physicians look for recurrence through clinic visits, blood tests, and a recommended 15 CT scans in five years – an expensive, time consuming method that exposes patients to excessive levels of radiation.
 
In this trial, SWOG will study miR371 – which can be collected from a simple blood draw. The investigative team will confirm whether miR371 is a good determinant of relapse (and the need for additional treatment), and in fact whether it can replace some of the CTs currently recommended.
 
S1823 is a collaborative success story. It bridges our AYA and prevention committees; SWOG and our Canadian counterparts; SWOG and COG; and SWOG and The Hope Foundation, which sponsored the principal investigator, Dr. Lucia Nappi of the British Columbia Cancer Agency, through the Young Investigator Training Course. It’s also an important trial for our NCORP operation.
 
Stay tuned for much more to come, for this important and underserved population.