Clinician involvement in cancer clinical trials may be insufficient

Klabunde CN. J Natl Cancer Inst. 2011;103:1-14.

Issue: March 25, 2011

One-third of clinicians affiliated with a Community Clinical Oncology Program or a National Cancer Institute-designated center did not report enrolling patients in clinical trials in a recent 12-month period, according to study results.

Researchers from several sites in the US, including the NCI, aimed to determine the level of physician advocacy in facilitating patient participation in clinical trials. The researchers investigated the characteristics of 1,533 physicians who had enrolled colorectal and lung cancer patients in trials. They also investigated the types of trials involved.

Data for 496 medical oncologists, 228 radiation oncologists and 809 surgeons were drawn from the Cancer Care Outcomes Research and Surveillance Consortium.

The response rate of the survey, which was conducted from 2005 to 2006, was 61%.

Results indicated that 87.8% of medical oncologists, 66.1% of radiation oncologists and 35% of surgeons had referred or enrolled one or more patients in clinical trials during the previous 12 months.

Medical oncologists enrolled a mean of 17.2 (95% CI, 15.5-18.9) patients; the mean patient referral or enrollment was 9.5 (95% CI, 7.7-11.3) for radiation oncologists and 12.2 (95% CI, 9.8-14.6) for surgeons (P<.001).

Clinicians involved in teaching were more likely than those who did not teach to enroll patients in clinical trials, 87.4% vs. 75.8% (P=.003). Affiliation with a Community Clinical Oncology Program (CCOP) compared with no such affiliation was linked to increased likelihood of participation or enrollment in a clinical trial (86.1% vs. 77.8%; P=.016), as was affiliation with an NCI-designated center (89.7% vs. 79.2%; P=.023).

Physicians involved in CCOPs or the NCI referred or enrolled patients at a rate of 66.2%.

Physicians working in hospital settings were more likely to participate in clinical trials than those in office settings (P=.018).

Surgical oncologists were more likely than general surgeons to enroll patients in trials (P=.01). Thoracic surgeons and colorectal surgeons also were more likely than general surgeons to participate.

The researchers said participation in clinical trials must increase among clinicians. “Even among physicians with a CCOP or NCI-designated cancer center affiliation — environments specifically designed to support physicians’ clinical trials involvement — not all participated in trials,” they wrote.

Follow HemOncToday.com on Twitter.