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Patient supply, demand for pancreatic cancer clinical trials out of alignment
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The number and type of clinical trials for pancreatic cancer in the United States are not coordinated with actual patient demand, according to a recent study.
Researchers evaluated open US clinical trials for pancreatic cancer between 2011 and 2012. Trials were collected from the Pancreatic Cancer Action Network database, and sponsors provided accrual information. Survey responses from 761 individuals who received a clinical trial search also were evaluated.
In 2011, there were 133 open pancreatic cancer clinical trials, which increased to 167 in 2012. Nearly all studies incorporated patients with pancreatic ductal adenocarcinoma (PDAC); the majority focused on metastatic disease.
There were 1,804 patients accrued to 93.2% of open trials in 2011, with the total accrual representing an estimated 4.57% of the pancreatic cancer population. Open trials in 2011 achieved a mean of 15% of potential enrollment, and investigators calculated a mean of 6.7 years for these trials to achieve complete accrual.
To accrue the complete 2011 trial portfolio, 57% of patients with pancreatic neuroendocrine tumors, 83% of those with resectable PDAC, 26% with metastatic PDAC and 6% with locally advanced PDAC would require enrollment. Researchers said full accrual would require between 1.3 and 4.2 times the number of available patients, depending on disease type, and wrote that patient demand exceeds supply by twofold on average, even with recruitment of all eligible patients.
Among responders, 78 reported enrolling in a trial, with physician recommendation cited most commonly (48.7%). Two hundred fifty-three responders said the most frequent barriers to enrollment were inability or unwillingness to travel to the trial location (37.2%) or being too ill to participate (31.6%).
“In the case of pancreatic cancer clinical trials, more is not necessarily better,” the researchers wrote. “Attention should be paid to more closely matching the supply of clinical trials to the demand of the patients with pancreatic cancer, resulting in more options for current patients and acceleration in the development of new and better treatments for future patients.”
Disclosure: The researchers report no relevant financial disclosures.
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