Investigating strategies to improve clinical trial opportunities for patients with cancer in New Zealand—INSIGHT
August 2, 2019
Abstract
Background:Despite the importance of clinical trials, fewer than 5% of adult cancer patients are enrolled in them. Multiple patient (pt), clinician and institutional barriers have been identified. This study aimed to explore what factors impact access to cancer trials in NZ.
Methods: After ethics approval, a 28-point survey was circulated via 9 DHBs and 4 cancer foundations to pts with a cancer diagnosis. Questions covered demographics and potential factors that might impact participation in trials e.g. travel. A 23-point survey was sent to research staff across the 9 DHBs.
Results: Between July 2016 and June 2017, 691 pts responded; 63% were female, 77% were over the age of 50. Most pts (89%) knew of clinical trials and 86% would consider participating in a trial. The proportion did not differ by age, location, income, tumor type or gender. 44% would consider treatment at a different hospital, and 11% would consider relocating for a trial. 130 pts (19%) had been on a trial of whom only 3 pts (2%) would not consider a trial in the future. Only 10% thought trials should be a last resort. Participation factors seen as advantages included: benefiting others (such as doctors’ research) (93%), better treatment (70%), more scans and longer follow-up (51%). Disincentives for participation included fear of randomization (78%), treatment toxicities (72%), time and cost of more visits (40%) and unspecified future use of tissue (33%). Of 111 responses from research staff, 54% had experience as either a principal investigator (PI) or sub-PI. The 3 most commonly reported barriers by research staff were time (73%), money (70%) and infrastructure (49%). Researchers felt additional tests, language issues and pt awareness of trials were key barriers to pt participation.
Conclusions: The identified barriers to trial participation appear similar in NZ to other developed countries. In this motivated cohort, many pts did not mind extra travel or tests, in contrast to perceptions of the research team. There is a strong interest from pts with cancer to consider participation in trials at any stage of their treatment. This suggests that addressing the areas of clinician and infrastructure barriers may help improve access to clinical trials in NZ.
Source:
So, Y., Anderson, M. C., Findlay, M. P., Gregory, K., Jackson, C., Jameson, M. B., . . . Wilson, M. K. (2018). Investigating strategies to improve clinical trial opportunities in oncology in New Zealand (INSIGHT). Journal of Clinical Oncology, 36(15_suppl). doi:10.1200/jco.2018.36.15_suppl.e18851