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  • Review Article
  • Published:

Adolescent and young adult patients with cancer: a milieu of unique features

Nature Reviews Clinical Oncology volume 12, pages 465–480 (2015)Cite this article

Subjects

Key Points

  • Adolescent and young adult (AYA) patients with cancer are a unique subgroup of patients that might receive treatment from oncologists specializing either in the treatment of children or older adults

  • The types of cancers seen in AYA patients, as well as the type of support and ancillary services required, differ from those of paediatric or older adult patients

  • The 5-year survival of AYA patients with cancer has, in general, increased over the past 30 years, although cancer remains a leading cause of death for this age group

  • Clinical trials and emerging technologies have enabled improved understanding of 'host' biology and treatment approaches in AYA patients diagnosed with cancer

  • Unlike paediatric or older adult patients with cancer, fewer clinical trials are conducted to investigate outcomes of AYA patients, who often also lack access to age-appropriate psychosocial and health services

  • Understanding of long-term survivorship in patients initially diagnosed with cancer while AYAs is limited and, presently, is extrapolated largely from what is known about patients diagnosed as children

Abstract

Adolescent and young adult (AYA) patients with cancer are a unique category of patients who, depending on age at time of diagnosis, might receive treatment from oncologists specializing either in the treatment of children or adults. In the USA, AYA oncology generally encompasses patients 15–39 years of age. AYA patients with cancer typically present with diseases that span the spectrum from 'paediatric' cancers (such as acute lymphoblastic leukaemia [ALL] and brain tumours) to 'adult' tumours (such as breast cancer and melanoma), as well as cancers that are largely unique to their age group (such as testicular cancer and bone tumours). Research indicates that outcomes of AYA patients with cancer are influenced not only by the treatment provided, but also by factors related to 'host' biology. In addition to the potential biological and cancer-specific differences between AYAs and other patients with cancer, AYA patients also often have disparate access to clinical trials and suffer from a lack of age-appropriate psychosocial support services and health services, which might influence survival as well as overall quality of life. In this Review, these issues are discussed, with a focus on two types of AYA cancer—ALL and melanoma—highlighting findings arising from the use of emerging technologies, such as whole-genome sequencing.

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Figure 1: The ABCDE criteria for melanoma identification.

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Authors and Affiliations

  1. Division of Hematology–Oncology, Department of Medicine, School of Medicine, University of California, Irvine, 101 The City Drive South, Orange, 92868, CA, USA

    Leonard Sender

  2. Hyundai Cancer Institute, Children's Hospital of Orange County, 1201 West La Veta Avenue, Orange, 92868, CA, USA

    Keri B. Zabokrtsky

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Both authors researched the data for the article, and contributed substantially to discussion of content. Both authors wrote the article and reviewed and edited the manuscript before submission.

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Sender, L., Zabokrtsky, K. Adolescent and young adult patients with cancer: a milieu of unique features. Nat Rev Clin Oncol 12, 465–480 (2015). https://doi.org/10.1038/nrclinonc.2015.92

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