Clinical Trial Participation Low in Lung, Colorectal Cancers

Despite the importance of clinical trials for driving medical discovery and innovations, only 14% of patients with newly diagnosed lung or colorectal cancer surveyed in a recent trial reported having discussed participation in clinical trials with their physician, and even fewer went on to participate.

“Even among patients treated with chemotherapy for advanced cancer, for whom investigational approaches should arguably be integrated into all initial considerations about treatment options, given a low chance of cure with standard therapy, the discussion rate was only 25.7%, with a participation rate of 7.6%,” wrote researchers led by Kenneth L. Kehl, MD, MPH, of Harvard Medical School.

Kehl and colleagues also found that discussions occurred less frequently among older patients, and black and Asian patients compared with white patients.

In the study, the researchers surveyed 7,887 patients with lung or colorectal cancer between 3 and 6 months after cancer diagnosis. Respondents were asked if they learned that clinical trial participation might be an option for them, and who discussed trials with them. The results were published in the Journal of the National Cancer Institute.

Overall, 1,114 participants, or 14.1%, reported having discussed the possibility of participating in a clinical trial, with the majority reporting that the discussion occurred with their physician. Participating in a clinical trial occurred in 3.6% of all participants and in 25.8% of participants who reported discussing clinical trials with their physician. In addition, higher rates of clinical trial discussion occurred among patients who reported being treated by a medical oncologist compared with those who were not.

Among the 2,173 patients with advanced disease, 25.7% reported discussing participation in a trial and 7.6% enrolled in a trial.

Kehl and colleagues found that younger age, increasing education, higher income, lung cancer, and more advanced disease were all associated with an increased likelihood to have had a discussion about participation in a clinical trial. Additionally, patients who reported sharing in the decision-making process with their physician were more likely to participate in a clinical trial compared with those patients who reported physician-controlled decisions.

“These findings indicate that improving trial accrual and participation rates may require a two-pronged approach,” the researchers wrote. “First, trial availability and access must be expanded and patients educated about the option of enrollment. Second, enhanced efforts to address patient concerns about trials and to optimize communication between providers and eligible patients may further increase participation.”