More Adults Are Participating in Cancer Clinical Trials

TOPLINE: 

New estimates show that patient enrollment in cancer clinical trials focused on treatments is about twice as high now compared with past estimates, with rates at National Cancer Institute–designated centers reaching more than 20%. Still, the overall rate of clinical trial participation remains low and is influenced by the institution where patients receive care. 

METHODOLOGY: 

Decades-old national estimates indicate that only 2%-3% of adults with cancer participate in clinical trials. However, these outdated estimates focus on patient enrollment in treatment trials only. To provide more recent estimates spanning different types of clinical trials, researchers analyzed data from 1200 Commission on Cancer programs, which represent more than 70% of all cancer cases diagnosed in the United States each year. The researchers assessed annual enrollment in a variety of study types, including those focused on treatments, diagnostics, economic, genetics, prevention, quality of life, and registry data, between 2013 and 2017. 

TAKEAWAY:

The researchers estimated that 7.1% of adults with cancer participated in treatment trials between 2013 and 2017, more than two times higher than the historical estimates of 2%-3%. When all trial categories were examined together, about 1 in 5 (21.9%) patients participated in at least one cancer clinical research study. Among all trial categories, enrollment was highest at National Cancer Institute (NCI)–designated comprehensive cancer centers. For instance, more than 1 in 5 patients (21.6%) at NCI-designated centers participated in treatment trials. By contrast, community cancer programs had the lowest enrollment in treatment trials at 4.1%. Enrollment was in other settings was slightly higher: 5.4% at non–NCI-designated academic cancer centers and 5.7% at integrated network cancer programs. Patients participated in many other types of trials, including biorepository (12.9%), registry (7.3%), genetic (3.6%), quality of life (2.8%), diagnostic (2.5%), and economic (2.4%) studies. 

IN PRACTICE: 

“These contemporary data provide encouraging insights about the increasing numbers of people with cancer participating in cancer clinical research studies, including but not limited to cancer treatment studies,” Stephanie B. Wheeler, PhD, MPH, associate editor, Journal of Clinical Oncology, wrote in the context section of the study. Still, given the lower participation rates in the community setting and at non–NCI-designated programs, “more efforts are needed to expand study access and to anticipate and mitigate barriers to clinical research participation, especially among underrepresented groups.”

SOURCE: 

The study, with first author Joseph M. Unger, PhD, from Fred Hutchinson Cancer Center, Seattle, Washington, was published April 2 in the Journal of Clinical Oncology.

LIMITATIONS:

Commission on Cancer–approved institutions are larger, are more often located in urban centers, and have more cancer-related services available to patients than are nonapproved institutions, which could limit the generalizability of the study findings. Individual patient–level factors, such as sex, race, ethnicity, or geography, were unavailable. Trends over time could not be evaluated. 

DISCLOSURES: 

Support for the study was provided by the Public Health Sciences Division of the Fred Hutchinson Cancer Center. Unger reported a consulting/advisory role for AstraZeneca.

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