1. Barriers to Study Enrollment in Patients With Advanced Cancer Referred to a Phase I Clinical Trials Unit
- Author
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Siqing Fu, Sarina Anne Piha-Paul, Adrienne Howard, Dennis Tu, Gerald S. Falchook, David S. Hong, Lacey McQuinn, Jennifer J. Wheler, Filip Janku, Apostolia Maria Tsimberidou, Razelle Kurzrock, Aung Naing, and Ralph Zinner
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Phases of clinical research ,Outcomes Research ,Patient referral ,Neoplasms ,medicine ,Humans ,In patient ,Patient participation ,Referral and Consultation ,Aged ,Retrospective Studies ,Clinical Trials, Phase I as Topic ,business.industry ,Hospices ,Retrospective cohort study ,Middle Aged ,Advanced cancer ,Oncology ,Clinical trials unit ,Physical therapy ,Female ,Patient Participation ,business - Abstract
We conducted this retrospective study to identify reasons that patients referred to a phase I clinical trial failed to enroll or delayed enrollment onto the trial.Outcome analyses were conducted independently on data collected from electronic medical records of two sets of consecutive patients referred to a phase I clinical trial facility at MD Anderson Cancer Center. Data from the first set of 300 patients were used to determine relevant variables affecting enrollment; data from the second set of 957 patients were then analyzed for these variables.Results from the two sets of patients were similar. Approximately 55% of patients were enrolled in a phase I trial. Patients referred from within MD Anderson were more likely to be enrolled than patients seen originally outside the institution (p = .006); black patients were more likely than white patients to enroll (69% vs. 43%; p = .04). The median interval from the initial visit to initiation of treatments was 19 days. Major reasons for failure to enroll included failure to return to the clinic (36%), opting for treatment in another clinic (17%), hospice referral (11%), early death (10%), and lack of financial clearance (5%). Treatment was delayed for three weeks or more in 250 patients; in 85 patients (34%), the delay was caused by financial and insurance issues.Failure to return to the clinic, pursuit of other therapy, and rapid deterioration were the major reasons for failure to enroll; lengthy financial clearance was the most common reason for delayed enrollment onto a phase I trial.
- Published
- 2013