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“ Barriers to enrolling patients with ovarian cancer in clinical trials in the state of Oregon ” Fabio Cappuccini, MD, Analene Pentopoulos, MD Gynecologic Oncology Oregon Health & Science University Center for Women’s Health March 25, 2006. Enrollment in Clinical Trials.
“Barriers to enrolling patients with ovarian cancer in clinical trials in the state of Oregon”
Fabio Cappuccini, MD, Analene Pentopoulos, MD
Oregon Health & Science University
Center for Women’s Health
March 25, 2006
In the past decade, clinical trial enrollment rates ranged from 3% for breast cancer to 14% for all cancer patients.
Greater than 70% of children are enrolled, but only 1.5% of adult patients ≥ 50.2
1. Lara PN, Higdon R, Lim N, Kwan K, et al. Prospective evaluation on cancer clinical trial accrual patterns: Identifying potential barriers to enrollment. Journal of Clinical Oncology. 19(6) 2001: 1728-1733.
2.Kornblith AB, Kemeny M, Peterson BL et al. Survey of oncologists’ perceptions of barriers to accrual of older patients with breast carcinoma to clinical trials Cancer 2002;95:989-96.
1. Comis RL et al. Public attitudez toward participation in cancer clinical trials. J Clin Oncol 2003;21:830-35.
2. Ellis PM et al. Randomized clinical trials in oncology: Understanding and attitudes predict willingness to participate. J Clin Oncol 2001;19:3554-61.
Kinney AY et al. Ther effect of physician recommendation on enrollment in the Breast Cancer Chemoprevention Trial. Prev Med 1998;27:713-9
Mannel RS et al. Impact on individual physicians on enrollment of patients into clinical trials. Am J Clin Onco2003;26:171-3
Between 1999 and 2003, there were 1262 cases of ovarian cancer reported to OSCaR
637 – patients are alive
560 – surveys initially mailed
305 -- surveys have been returned
43 – declined to answer
262 – available for analysis
99.3% of respondents underwent surgery
Chemotherapy was discussed with 89.6% of respondents
Of the women offered a clinical trial, 53% accepted enrollment
Desire to help future patients 18/19
Desire to advance research 17/19
Recommendation of MD 15/19
Recommendation of family/friend 7/19
Hope for better treatment 10/19
Trial was well explained 16/19
Most women in Oregon with ovarian cancer do not know about clinical trials.
Only a small percentage of women with ovarian cancer are offered enrollment in clinical trials by their physician limiting the number of women available for enrollment.
“ I have always asked if there was a trial I would benefit. The answer was no…I feel it is the responsibility of the oncologist to determine and let you know what’s out there instead of the patient asking if there is anything out there that would be of help”
“ The clinical trials I am on or did consider were the result of research my husband did online…it seems the prospect of clinical trials is the responsibility of the patient”
“ It is my hope that clinical studies will begin to include older people – people in their 80’s and beyond. We would like to have the option of living longer too, if given the chance”
“ In spite of a poster…saying to ask about clinical trials, I always felt that there was a pervasive strong underlying reluctance to explore the possibility”