Clinical trials what are they and when are they right for you
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Clinical Trials What Are They and When Are They Right For You?. Maura N. Dickler Assistant Attending Physician Breast Cancer Medicine Service Memorial Sloan-Kettering Cancer Center. What is a Clinical Trial?. A study designed to answer a specific question Drug development

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Clinical trials what are they and when are they right for you

Clinical TrialsWhat Are They and When Are They Right For You?

Maura N. Dickler

Assistant Attending Physician

Breast Cancer Medicine Service

Memorial Sloan-Kettering Cancer Center


What is a clinical trial
What is a Clinical Trial?

A study designed to answer a specific question

  • Drug development

  • New surgical technique

  • Psychosocial intervention

  • Long term side-effects of therapy


What goes into designing a clinical trial
What goes into designing a clinical trial?

  • Generate a hypothesis/ask a question

  • Design a trial to test that hypothesis

  • Involves a team of researchers including physicians from multiple disciplines and biostatisticians

  • Review by multiple committees

    • Scientific committees

    • Patient safety committees (Institutional Review Board or IRB)

    • FDA

    • National Cancer Institute (NCI)


Types of trials
Types of Trials

  • Phase 1: tests dose, schedule, feasibility

    • Primary endpoint: side effects

  • Phase 2: tests whether the drug or combination works

    • Primary endpoint: effectiveness

    • All patients have the same disease

  • Phase 3: randomized trial

    • Primary endpoint: is one therapy better than the other


Different trial designs
Different Trial Designs

  • Open label

  • Blinded

  • Placebo-controlled


Who is eligible to participate
Who is Eligible to Participate?

  • Inclusion criteria

    • Type of breast cancer (e.g. ER+, HER2+)

    • Measurable or non-measurable disease

  • Exclusion criteria

    • Pre-existing conditions

    • Baseline organ function (e.g. good blood counts, normal kidney function)


Informed consent
Informed Consent

  • What is the informed consent?

  • Why is it necessary?

  • What information is provided?

    • Rationale of the trial

    • Who can participate

    • Risks/benefits

    • Side effects

    • What is covered by the trial vs. what will be billed to insurance


When is a trial right for you
When is a Trial Right for You?

  • Talk with your physician

  • Utilize resources available on the web

    • NCI website

    • Academic websites

  • Seek other opinions at academic centers

  • Talk with fellow patients/advocates

  • Be your own advocate, but you should not feel alone


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