Abstract B096: Clinical trial enrollment amongst children and adolescents and young adults with primary central nervous system tumors at Columbia University Irving Medical Center

Abstract Background: Adolescents and young adults (AYAs; 15 – 39 years y) with central nervous system (CNS) tumors have worse survival than children with CNS tumors. Additionally, Hispanic and non-Hispanic Black (NH Black) children and AYAs have inferior outcomes relative to non-Hispanic White (NH White) patients. The reasons for these disparities in outcomes are likely multifactorial, but inequitable clinical trial enrollment (CTE) rates may contribute. Objective: To evaluate rates and predictors of therapeutic CTE amongst children and AYAs treated for CNS tumors at Columbia University Medical Center (CUMC) in New York. Design/Methods: Rates of trial enrollment were measured amongst patients 40y treated for CNS tumors at CUMC from 01/01/2010 – 12/31/2020. Demographic and clinical data were abstracted from medical records. Home Owners’ Loan Corporation (HOLC) grade and Yost index were derived from residential address and were used as proxies for neighborhood residential segregation and area deprivation, respectively. Trial enrollment was defined as yes/no regardless of enrollment on multiple trials. Logistic regression assessed factors associated with enrollment. Results: Among 1,005 patients, 31% (N = 312) were 0 – 17y at diagnosis and 69% (N = 693) were 18 – 39y. Relative to the AYA cohort, a significantly higher proportion of children were Hispanic (24% vs 12%), NH Black (12% vs 6%), publicly insured (29% vs 11%), and from more socioeconomically disadvantaged neighborhoods. Overall, 11% of patients enrolled on a therapeutic trial. In multivariable analyses, age was the primary predictor of CTE, with AYAs being less likely to enroll than children (odds ratio = 0.6, 95% confidence interval 0.4 – 0.9). Patient sex, race/ethnicity, insurance at diagnosis, and Yost index were otherwise not predictive of CTE overall or by age group. Conclusion: Among a diverse cohort of pediatric and AYA patients with primary CNS tumors, age was the primary predictor of CTE. Within age groups, all patients had equal rates of enrollment regardless of race/ethnicity, insurance status, or neighborhood socioeconomic status. Lower rates of AYA CTE may reflect trial availability for the tumor types prevalent in this age group, or of treatment in medical (versus pediatric) oncology. Further work is needed to elucidate enrollment barriers for AYAs with CNS tumors to develop targeted interventions. Acknowledgment: Supported by a research grant from the Investigator-Initiated Studies Program of Merck Sharp the opinions reflected herein are those of the authors only. Citation Format: Kathryn McHenry, Rohit Raghunathan, Sarah Kleinknecht, Katherine MacNeil, Claire Chanatry, Dawn Hershman, Melissa Beauchemin, Justine Kahn. Clinical trial enrollment amongst children and adolescents and young adults with primary central nervous system tumors at Columbia University Irving Medical Center abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B096.