Many Patients With Cancer Still Face Barriers to Clinical Trial Participation

A study published in the Journal of the National Cancer Institute found that more than three out of four patients with cancer may face barriers to joining a clinical trial.

Systemic barriers mount

β€œThe reason most patients don’t go into clinical trials is not because of the patient, but because of all the barriers in front of the patient, including structural and clinical factors,” the study’s lead author, Joseph Unger, PhD, MS, of the Fred Hutchinson Cancer Research Center in Seattle, told Reuters.

The researchers conducted a systematic review of PubMed, Google Scholar, Web of Science, and Ovid Medline to identify studies that examined the trial decision-making pathway using a uniform framework to characterize and quantify structural (trial availability), clinical (eligibility), and patient/physician barrier domains.

The final sample included 13 studies (nine in academic and four in community settings) spanning 15 years that involved 8,883 patients.

Low clinical trial enrollment rateβ€”just 8%

Researchers found that just 8.1% of patients in the studies enrolled in a clinical trial (95% CI, 6.3-10.0).

For more than half of patients (55.6%), a clinical trial was unavailable at their institution (95% CI, 43.7-67.3). In addition, 21.5% of patients were ineligible for an available trial (95% CI, 10.9-34.6). Another 14.8% did not enroll in a clinical trial (95% CI, 9.0-21.7).

Clinical trial setting matters

Researchers observed a difference in rates of trial enrollment in academic (15.9%; 95% CI, 13.8-18.2) versus community (7.0%; 95% CI, 5.1-9.1) settings, but they did not observe different rates of trial unavailability, ineligibility, or non-enrollment based on setting.

β€œThese findings emphasize the enormous need to address structural and clinical barriers to trial participation, which combined make trial participation unachievable for more than three of four cancer patients,” the researchers concluded.

Source: Journal of the National Cancer Institute