Not Enough Cancer Patients Enroll in Potentially Life-Extending Clinical Trials

According to the findings of a study published in the Journal of the National Comprehensive Cancer Network enrollment in life-extending clinical trials for cancer treatment is low, except among white males with private insurance.

In this study, a team of Penn State Cancer Institute researchers assessed data from more than 12 million patients with 46 different types of cancer between 2004 and 2015 in the National Cancer Database. Subsequently, they performed a stratified analysis in which they matched each patient who participated in any clinical trials with another patient who was not enrolled in a trial that had ten similar characteristics — including cancer type, age, race, insurance type, disease stage, and whether or not surgery or chemotherapy were part of the treatment plan.

The researchers observed that only 11,576 (0.1%) of those patients enrolled in clinical trials as their first course of therapy following diagnosis. “Major advances in cancer treatment have been supported by clinical trials,” said Dr. Niraj J. Gusani, professor of surgery, Penn State College of Medicine, and senior author of the study in a press release. “By volunteering to participate in a trial, patients may help further the field of research and gain access to new treatments.”

According to Dr. Nicholas G. Zaorsky, previous evaluations of whether clinical trials improved survival compared patients who were enrolled in trials against those not enrolled in trials — but didn’t account for factors like age, race, gender and cancer type.

“If you’re going to evaluate whether clinical trial enrollment is beneficial for patients, you have to try and match each patient to someone who has a similar cancer and sociodemographic profile,” Zaorsky said. “Otherwise, it is like comparing apples to oranges.”

Dr. Gusani added that: “If clinical trials are going to be used to determine standards of care for the general population, then the study participants need to be representative of the general population — and this study shows that often this isn’t the case.”