Improving participation in cancer clinical trials
By Dr P. Kosmidis, Medical Oncologist
Throughout the years of my clinical practice I have witnessed the importance of clinical trials for research and development of new cancer treatments. Still, today only a minority of patients are aware of the therapeutic potential available to them and even less are successful in finding one that is suitable for them.
Low patient enrollment holds everyone back
Undoubtedly, recruiting cancer patients for clinical trials can be extremely difficult. and I have repeatedly faced this barrier in trials I took part in, as an investigator. Sadly, this leads to grim statistics:
- According to CenterWatch, 81% of clinical trials are delayed due to inadequate participant recruitment.
- 50% of clinical research sites enroll one or no patients, according to the Center for Information and Study on Clinical Research Participation (CISCRP).
- The American Cancer Society reports that less than 5% of adult cancer patients participate in trials.
- In 2015, the Clinical Trials Transformation Initiative analyzed the recruitment performance of registered trials. It discovered that 19% of trials were either cancelled or discontinued due to low enrolment, and almost 9 out of 10 failed to achieve their recruitment targets within their deadlines.
The patients’ perspective
These statistics are not a surprise to me or other researchers. Judging by how challenging it is for professionals to stay informed about clinical trials, we can only imagine the difficulties patients would face.
However, I was surprised to receive the results of a patient survey ran by our analysts at CareAcross, an online platform for cancer patients: 81% of cancer patients had received no information about clinical trials from their doctor.
In the same survey, CareAcross asked members about their perceptions on trials, and 83% believe that clinical trials can save lives or are the best way to discover new treatments! Moreover, the majority of patients on the CareAcross platform would be interested to participate in a clinical trial themselves.
On the other hand, only 5% of cancer patients had searched for a trial and found it to be easy task.
It seems, therefore, that patients actually do not get to hear about clinical trials from their doctors, who are the very people that the industry relies upon for effective dissemination of information. Moreover, despite patients’ intentions, searching for a trial appears an overwhelming task for them.
Paradigm shift: Long-term access to patients is key to successful trials
These challenges and statistics show that a paradigm shift is necessary. It is no longer sufficient to engage investigators to reach out to patients for clinical trials, as this is highly timing-dependent and also requires that the clinician has immediate and unobstructed access to the patient. Even if, in the past, relying on oncologists for this task could scale, it does not scale now.
Clinical Trial Matching powered by CareAcross
Clearly, technology can play a critical role in facilitating long-term access to patients.
At CareAcross, we always place the patient at the center of our digital platforms, and offer 100% personalized information and services. This way we ensure they always receive the most relevant information to address their needs - in a patient-friendly language. Through this approach, CareAcross engages with thousands of cancer patients on a long-term basis and, through ongoing data collection, it maintains an up-to-date profile for each patient. The collected data includes, for example, the exact diagnosis, present or past treatments, other medications and co-morbidities, and more; for specific tumor types it may include genetic mutations or relevant biomarkers.
As a result, with the help of advanced dynamic algorithms, the platform can effectively match patients with clinical trials that may be applicable, based on their corresponding inclusion and exclusion criteria. Moreover, thanks to the long-term engagement with these patients, CareAcross guides them in order to understand their options and navigate through the necessary next steps.
Of course, these processes are always conducted in a respectful manner towards patients, as well as towards their privacy and data protection rights.
Listening to our patients
Along with their responses to the CareAcross survey, patients added various interesting comments - some of which I quote below (anonymously, of course):
“I tried to [get into a] trial for advanced prostate cancer; oncologist was very dismissive. [It was] impossible to get help; no support available.”
“The oncologist said there were not any clinical trials just now”
“I was told about it but treatment was started without asking if I would like to participate”
“With the number of new treatments, I feel it is necessary to start as soon as possible, not wait until the illness become uncontrollable”
About the author
Paris Kosmidis, MD, has more than 40 years of experience as an oncologist at large medical institutions in the USA and Europe. He is a past President of the European Society of Medical Oncology (ESMO), and the author or co-author of hundreds of publications featured in leading, high-impact factor international oncology journals. He has participated as Investigator or Principal Investigator in numerous clinical trials.
Dr Kosmidis is Chief Medical Officer at CareAcross.