Increasing Participation in Cancer Trials: A New Insight
Key Takeaways
- Recent research reveals that from 2013 to 2017, 7.1% of U.S. cancer patients participated in clinical trials, a significant increase from historical estimates of less than 5%.
- Pharmaceutical company-sponsored trials contribute to the higher participation rates observed, surpassing previous estimates based solely on National Cancer Institute-sponsored trials.
- Effective strategies to further enhance trial enrollment include building infrastructure and providing staff support at non-NCI-designated sites, which are key focuses of the Cancer Moonshot and National Cancer Plan initiatives.
Did You Know?
Introduction to Cancer Treatment Trials
Recent research has shown that participation in cancer treatment clinical trials is higher than past estimates. Based on data from the Commission on Cancer, it was found that from 2013 to 2017, about 7.1% of patients participated in these trials, a significant increase from historical estimates of less than 5%. This conclusion was drawn by Joseph M. Unger, PhD, from the Fred Hutchinson Cancer Center, along with his team.
Comparison with Previous Studies
Previous studies often based their participation estimates on National Cancer Institute (NCI)-sponsored cooperative group trials, which only estimated a participation rate between 1.5% and 4%. However, these new findings consider additional trials sponsored by pharmaceutical companies, which enroll a considerable number of participants.
Global Perspective
The participation rate of 7.1% in the U.S. aligns with those reported in other industrialized nations like the U.K. and France. Interestingly, about 21.9% of patients contribute to some form of clinical research study overall, suggesting that participation in cancer clinical research is more common than previously acknowledged.
Impact on Cancer Moonshot and National Cancer Plan
Dr. Catherine C. Fahey and Dr. W. Kimryn Rathmell, in their editorial, highlighted that these findings have crucial implications for initiatives like the Cancer Moonshot and the National Cancer Plan. They emphasized the importance of real-world data, noting that the study provides a significant update on clinical trial enrollment patterns.
Data Collection and Analysis
The Commission on Cancer requires its member institutions to submit accreditation information every three years, which includes details on clinical trial enrollments. This study used data from 1,200 programs, representing over 70% of cancer cases diagnosed annually in the U.S. The types of programs included community cancer programs, academic comprehensive cancer programs, integrated network cancer programs, and NCI-designated comprehensive cancer centers.
Participation in Various Study Types
Besides cancer treatment trials, participation was also estimated for other study types such as biorepository, registry, genetic, quality of life, diagnostic, and economic studies. Overall participation in any study category was estimated at 21.9%, but this figure dropped to 14.3% if biorepository and registry studies were excluded.
Variation Across Program Types
Enrollment rates varied significantly among different program types. For instance, NCI-designated centers had a 21.6% participation rate, while community programs had only 4.1%. This highlights the need for data that represents a range of clinical settings.
The Need for Improved Infrastructure
Unger and colleagues pointed out that NCI-designated centers receive dedicated federal funds to conduct trials, unlike most community-based sites. Enhancing trial enrollment will require building infrastructure and providing staff support at these non-NCI-designated sites.
Workforce Optimization
Improving trial participation also means optimizing the workforce, which is a priority of both the National Cancer Plan and Cancer Moonshot initiatives. It’s crucial to ensure that all centers have the necessary support to conduct clinical trials.
Study Limitations
The researchers did acknowledge some limitations to their study. For example, institutions within the Commission on Cancer are typically larger, urban-based, and have more cancer-related services, which could affect the generalizability of participation estimates. Additionally, the study did not examine trial participation based on sex, race, ethnicity, or geography.
