MDNews - San Antonio

unacceptable," says Dr. Bowhay-Carnes, co-director of the AYA Cancer Program at University Hospita l and Assistant Professor of Medicine and Pediatrics at UT Health San Antonio. "Our goal as cancer care providers is to help people live longer and cure them if at all possible." With their colleagues, the two phy- sicia ns set a process in motion that ha s resulted in the la rgest inpatient AYA pr o g r a m i n Te x a s , hou s e d a t University Hospital. The team began shaping the program by asking some basic questions: How many AYA patients are in the Health System? How are they arriving at the hospital? What is the best location for their care? Why are they falling through the cracks? THE NEED FOR ACCESS TO CLINICAL TRIALS One of the big takeaways was the lack of access to clinical trials. "This age group is the most underrepre- sented in clinical trials, which is how we learn about the biological characteristics of diseases and tumors and how they interact. If we don't have access to this age group for clinical trials, we don't have access to that information," Dr. Bowhay- Carnes says. There is a direct correlation between the five-year survival rate of AYA cancer patients and the number who participate in clinica l tria ls, she adds. The lower the participation in trials, the lower the survival rate. The team discovered age is often a bar- rier to participation. Pediatric trials may have a cutoff age of 18, while adult cancer studies may not accept patients younger than 40 or 50 years old. When clinical trials are willing to accept enrollees outside the usual age ranges, AYA patients and their doctors often don't know about the trials. Dr. Grimes remembers a young woman i n her 20s who wa s d ia g nosed w it h pre-B acute lymphoblastic leukemia, a common ty pe of ca ncer in children. She qua lif ied for a potentia lly life- s av i n g p e d i at r ic clinical trial avail- able to patients as old as 30. However, becau se she wa s being treated in the adult program, her medica l providers didn't know that. DEVELOPING THE AYA CANCER PROGRAM AT UNIVERSITY HOSPITAL To b et t er m at ch AYA patients with t r i a l s a n d o t h er resources, the doctors and the AYA team have created a specia l a lgorithm. It collects data about cancer patients entering treatment at various locations, then matches their profiles with clinical trials for which they might qualify. The team is collecting data to measure the success of the process over the program's first five years, though they already know more of their patients are gaining access to the research studies. The search for solutions a lso led to another realization. AYA patients were scattered among three different areas of the hospital, which made coordinating care and communication a big challenge. That led to the new AYA inpatient unit that opened in December 2018 with eight full-time beds that can be expanded to 12. " Now t hat t hey 're a l l in t he sa me location, it helps our ability to screen patients for eligible clinical trials and consolidate services for these patients," says Dr. Grimes. A NATIONAL DONATION AND SPECIALIZED CARE Recently, Teen Cancer America awarded the AYA Cancer Program at University Hospital $296,000. It's one of just 30 hos- pital grants provided by the nonprofit, which was started by rock musicians Roger Daltrey and Peter Townsend of The Who. Allison Grimes, MD, Director of the AYA Cancer Program at University Hospital, counsels patient Hussam Alsaffar in the AYA unit. Aaron Sugalski, DO, visits with teen patient Victoria Brewer as she receives an infusion treatment in University Hospital's AYA Outpatient Clinic. M D N E W S . C O M /// M D N E W S S A N A N T O N I O ■ 2 019 0 7

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