The challenge of access to care for soft tissue sarcomas bridging pediatric and adult age: the Italian pediatric oncology view

Abstract

Synovial sarcoma and rhabdomyosarcoma are two high-grade soft tissue sarcoma subtypes that occur in adolescents and young adults. Managing these malignancies in patients in this age bracket poses various clinical problems, partly because different therapeutic approaches are sometimes adopted by pediatric and adult oncologists, even though they are dealing with the same condition. In this review, the doubts concerning how best to manage soft tissue sarcomas in patients between pediatric and adult ages lead up to a more general discussion of the issue of access to optimal cancer services for adolescents and young adults – a subset of patients acknowledged as being under-represented in clinical trials on therapies that may improve their outcome. The situation in Italy is described, along with action taken in an effort to bridge the gap and implement specific programs tailored to these patients.

Keywords::

• access to care
• adolescents
• clinical trials
• rhabdomyosarcoma
• soft tissue sarcomas
• synovial sarcoma
• young adults

Acknowledgements

The authors are grateful to the Associazione Bianca Garavaglia (Busto Arsizio, Italy) for supporting the Youth Project at the Pediatric Oncology Unit of the Istituto Nazionale Tumori (Milan, Italy). The authors would also like to thank Charles Pittman, Gaetano Pappuini and Pietro Ferrari.

Financial & competing interests disclosure

The authors would like to thank the Associazione Italiana per la Ricerca sul Cancro (Rome, Italy) for supporting research on rhabdomyosarcoma at the pediatric oncology unit of the Istituto Nazionale Tumori (Milan, Italy; grant IG 10445). The authors are grateful to the Fondazione Città della Speranza for supporting Italian and European data management for pediatric patients with soft tissue sarcoma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.