Trying out the CTSU

This last weekend I attended the Children’s Oncology Group Fall Meeting in Denver. As an adult oncology fellow, this was my first time at a pediatric oncology meeting, and the experience was instructive. Though there was industry sponsorship to help defray certain meeting costs, and though there were several vendor booths adjacent to the main gathering space, the relative pervasiveness of pharmaceutical influence was certainly less than at other meetings I have attended. I don’t think that children are as attractive commercial targets as are adults.

In any event, my main purpose in attending the meeting was to participate in the Adolescent and Young Adult Oncology subcommittee meeting, and to meet several individuals who I’d previously known through reputation and e-mail messages only. For background about the AYA movement in oncology, you can view the Adolescent and Young Adult Oncology Progress Review Group through the Lance Armstrong Foundation website.

An important development highlighted during the COG plenary session and again during the AYA subcommittee meeting was the upcoming participation of the Children’s Oncology Group in the NCI Clinical Trials Support Unit (CTSU). Many of you may already be familiar with the CTSU through your participation in the adult cooperative groups. Briefly, the CTSU enables participation for cooperative group member institutions in specified clinical trials offered by other NCI-funded cooperative groups as a way of enhancing accrual to trials and offering the greatest number of on- or off-trial treatment possibilities to patients. Institutions are offered additional credit for enrolling patients on these trials, though they will still need to go through their institutional IRBs and administrative paperwork to have the trials open. The trials offered through the CTSU are currently available in a menu on the website, and total 79 by my last check, across a wide range of diseases.

The enthusiasm from the COG for this initiative mainly comes from the implications for the adolescent and young adult population. For example, if an institution that treats mostly adults is not a COG member, it can now open up, via the CTSU, a COG trial that might have an appropriate, “pediatric-based” treatment regimen for an adolescent or young adult patient. This may be applicable for example in patients with sarcomas, or perhaps for certain pediatric leukemia or lymphoma protocols. As a side note, I would mention that these trials are not currently represented on the CTSU website though they will be in the future now that the COG is becoming an active participant.

Here are my questions for my readers: Are you familiar with the AYA movement? Are you a champion for AYA needs within your institution, or can you identify others who are? And can you envision a role for enrolling AYA patients on COG protocols within your institution? If not, is this because this is not applicable (i.e. your institution also treats pediatric patients and is already a COG member), or because you anticipate significant obstacles, or because you are not convinced that there is a need to do so?