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Low Enrollment in Clinical Trials Continues

By Lisa Schulmeister, MN, RN, ACNS-BC, OCN, FAAN
It’s well recognized that clinical trials are essential to progress in the field of oncology. Historically, clinical trials were available only at major cancer centers, but currently are available to patients at a variety of sites, including many community hospitals and practices. So why then does enrollment of adults in oncology clinical trials remain so low? It’s estimated that fewer than 5% enroll.

To determine barriers to enrollment, Kenneth L. Kehl, MD, from the Brigham and Women's Hospital in Boston, MA, and his colleagues surveyed a group of patients three to six months after the diagnosis of lung cancer or colorectal cancer. When patients were unavailable for interview, family members or individuals close to the patient were interviewed. One of the key questions asked was if clinical trial participation was offered as a treatment option, and if so, by whom and when.

Of 7,887 patients, 1,114 (14.1%) reported discussing clinical trial participation prior to initiation of treatment. Discussion of clinical trials was more common among college-educated patients and among those with incomes greater than $60,000 per year. Older patients and those who were African American and Asian, and those with comorbidities reported fewer discussions about clinical trials.

Most of the 287 who enrolled in a clinical trial (92.7%) learned about the trial from their healthcare providers, as opposed to other information sources, such as an internet search.  The majority of patients who declined clinical trial participation (92.7%) also reported learning about clinical trials from their healthcare providers rather than from other information sources. The bottom line is that only 287 patients enrolled in a clinical trial, or 3.6% of all patients. Although this represented 25.8% of those who discussed clinical trials, we still have a long way to go in increasing clinical trial enrollment.

Kehl KL, Arora NK, Schrag D et al. Abstract 6509. Presented at: 2014 American Society of Clinical Oncology Annual Meeting; May 30-June 3, 2014; Chicago, IL.
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