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Discussions About Clinical Trials Among Patients With Newly Diagnosed Lung and Colorectal Cancer

Year: 2014
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Clinical trials are essential to establish the effectiveness of new cancer therapies, but less than 5% of adults with cancer enroll in trials. In addition to ineligibility or lack of available trials, barriers to enrollment may include limited patient awareness about the option of participation. METHODS: We surveyed a multiregional cohort of patients with lung or colorectal cancer (or their surrogates) three to six months after diagnosis. We assessed whether respondents reported learning that clinical trial participation might be an option, and, if so, with whom they discussed trials. We used logistic regression to assess the association of patient characteristics with discussing trial participation and enrolling in trials. All statistical tests were two-sided. RESULTS: Of 7887 respondents, 1114 (14.1%) reported discussing the possibility of clinical trial participation; most learned about trials from their physicians, and 287 patients (3.6% of all patients, 25.8% of trial discussants) enrolled. Among 2173 patients who received chemotherapy for advanced (stage III/IV lung or stage IV colorectal) cancer, 25.7% discussed trials, and 7.6% (29.5% of trial discussants) enrolled. Discussions were less frequent among older patients, African American or Asian vs white patients, and those with lower incomes and more comorbidity. Enrollment was higher among patients reporting shared vs physician-driven decisions (all P < .05). CONCLUSIONS: In this population-based cohort, only 14% of patients discussed participation in clinical trials. Discussions were more frequent among advanced cancer patients but were still reported by a minority of patients. Strategies to expand access to trials and facilitate patient-provider communication about participation may accelerate development of better cancer therapeutics.
DOI: 10.1093/jnci/dju216
Authors: Kenneth L. Kehl, Neeraj K. Arora, Deborah Schrag, John Z. Ayanian, Steven B. Clauser, Carrie N. Klabunde, Katherine L. Kahn, Robert H. Fletcher, Nancy L. Keating
Institutions: Brigham and Women's Hospital, National Institutes of Health, RAND Corporation, Harvard University, University of California, Los Angeles, University of Michigan, Dana-Farber Cancer Institute, National Cancer Institute, Dana-Farber Brigham Cancer Center
Language: English
Field: Medicine
Open Access status: bronze
Awards: G2430596335, NC Colorectal Cancer Care Outcomes Research Study, Cancer Care Outcomes Research and Surveillance (CanCORS), G465357279, G4878863699, RAND-UCLA CanCORS PDCR Application, Deep South CanCORS Colorectal and Lung Cancer PDCR Site, Lung/Colon Cancer Outcomes--Cancer Research Network, G811783773, Cancer Care Outcomes Research &Surveillance Consortium
OpenAlex ID: W2148929016
FWCI: 3.976
Cites: 35
Cited by: 41
Related to: 10