Barriers to clinical trial enrollment for patients with gynecologic cancers: Why patients don’t participate and how to improve enrollment

The greatest barrier to clinical trial enrollment is patients not knowing an appropriate trial exists, according to a survey of gynecologic cancer survivors.

The most common reason survey respondents gave for not enrolling in clinical trials was that their medical team didn't tell them about any trials.

Annie Ellis and Mary (Dicey) Jackson Scroggins – who are both patient advocates and ovarian cancer survivors – conducted this survey and presented the results at the Society of Gynecologic Oncology’s Annual Meeting on Women’s Cancer last year (https://bit.ly/3plI1Vg).

Ms. Ellis discussed the survey results and other related research with host David H. Henry, MD, in this episode.

Ms. Ellis and Ms. Scroggins distributed their 26-question survey online. The survey was completed by 189 survivors of gynecologic cancers.

Most respondents (65.6%) had never participated in a clinical trial. Reasons for nonparticipation included:

• The medical team never discussed trial participation (50.4%)
• The patient didn’t qualify for a trial (14.4%)
• The trial location was too far away (7.2%)
• The desired trial wasn’t available (4.0%)
• Insurance didn’t cover trial participation (1.6%)
• The patient didn’t want to receive a placebo (11.2%), wasn’t interested in experimental therapies (3.2%), didn’t want to be randomized (2.4%), or didn’t trust the medical system (1.6%)
• Other reason (fill in the blank; 38.4%).

Roughly a third of respondents (34.4%) had participated in a clinical trial.

• Most of these respondents (86.2%) learned about the trial from their doctor.
• All past trial participants said they would participate again (84.6%) or they were not sure about future participation (15.4%).

Ms. Ellis also mentioned a recent review and meta-analysis, which showed that more than half of all cancer patients offered a clinical trial do participate (J Natl Cancer Inst. 2020 Oct 6. doi: 10.1093/jnci/djaa155. https://bit.ly/2Yg4dnP).

Together, these finding suggests cancer patients may be willing to participate in trials but often don’t know that relevant trials exist.

Ms. Ellis noted that her colleague, Ms. Scroggins, often says, “Patients can't go to the party if they don't get an invitation.”

Disclosures

Ms. Ellis, Ms. Scroggins, and Dr. Henry have no conflicts of interest.

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