Impact of a Clinical Trial Initiative on Clinical Trial Enrollment in a Multidisciplinary Prostate Cancer Clinic

Restricted access

Clinical oncology trials are hampered by low accrual rates, with fewer than 5% of adult patients with cancer treated on study. Clinical trial enrollment was evaluated at The University of Texas MD Anderson Cancer Center's Multidisciplinary Prostate Cancer Clinic (MPCC) to assess whether a clinical trial initiative, introduced in 2006, impacted enrollment. The trial initiative included posting trial-specific information in clinic, educating patients about appropriate clinical trial options during the treatment recommendation discussion, and providing patients with trial-specific educational information. The investigators evaluated the frequency of clinical trial enrollment for men with newly diagnosed prostate cancer seen in the MPCC from 2004 to 2008. Logistic regression evaluated the impact of patient characteristics and the clinical trial initiative on trial enrollment. The median age of the 1370 men was 64 years; 32% had low-risk, 49% had intermediate-risk, and 19% had high-risk disease. Overall, 74% enrolled in at least one trial and 29% enrolled in more than one trial. Trial enrollment increased from 39% before the initiative (127/326) to 84% (880/1044) after the trial initiative. Patient enrollment increased in laboratory studies (from 25% to 80%), quality-of-life studies (from 10% to 26%), and studies evaluating investigational treatments and systemic agents (from 6% to 15%) after the trial initiative. In multivariate analysis, younger men (P<.001) and men seen after implementation of the clinical trial initiative (P<.001) were more likely to enroll in trials. Clinical trial enrollment in the MPCC was substantially higher than that seen nationally in adult patients with cancer, and enrollment rates increased after the introduction of a clinical trial initiative.

Correspondence: Lydia T. Madsen, MSN, RN, Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Boulevard, Unit 1374, Houston, TX 77030. E-mail: lmadsen@mdanderson.org
  • 1.

    What are the key statistics about prostate cancer? American Cancer Society Web site. Available at: http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-key-statistics. Accessed June 4, 2014.

    • Search Google Scholar
    • Export Citation
  • 2.

    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:1130.

  • 3.

    Resnick MJ, Koyama T, Fan KH. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med 2013;368:436445.

  • 4.

    Gansler T, Jin M, Bauer J. Outcomes of a cancer clinical trial matching service. J Cancer Educ 2012;27:1120.

  • 5.

    Jacobs SR, Weiner BJ, Minasian LM. Achieving high cancer control trial enrollment in the community setting: an analysis of the Community Clinical Oncology Program. Contemp Clin Trials 2013;34:320325.

    • Search Google Scholar
    • Export Citation
  • 6.

    Janet Yang Z, McComas K, Gay G. From information processing to behavioral intentions: exploring cancer patients' motivations for clinical trial enrollment. Patient Educ Couns 2010;79:231238.

    • Search Google Scholar
    • Export Citation
  • 7.

    Comis RL, Aldige CR, Stovall EL. A quantitative survey of public attitudes towards cancer clinical trials. Available at: http://www.cancertrialshelp.org/CTHpdf/308-9.pdf. Accessed June 17, 2014.

    • Search Google Scholar
    • Export Citation
  • 8.

    Mohler JL, Kantoff PW, Armstrong AJ. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Version 2.2014. Available at: NCCN.org. Accessed June 26, 2013.

    • Search Google Scholar
    • Export Citation
  • 9.

    Patlak M, Nass S. Improving the Qualiy of Cancer Clinical Trials: Workshop Summary National Cancer Policy Forum. Washington DC: The National Academies Press; 2008.

    • Search Google Scholar
    • Export Citation
  • 10.

    Heiney SP, Arp Adams S, Drake BF. Successful subject recruitment for a prostate cancer behavioral intervention trial. Clin Trials 2010;7:411417.

    • Search Google Scholar
    • Export Citation
  • 11.

    Davison BJ, So A, Goldenberg SL. Measurement of factors influencing the participation of patients with prostate cancer in clinical trials: a Canadian perspective. BJU Int 2008;101:982987.

    • Search Google Scholar
    • Export Citation
  • 12.

    Biedrzycki BA. Factors and outcomes of decision making for cancer clinical trial participation. Oncol Nurs Forum 2011;38:542552.

  • 13.

    Wallace K, Fleshner N, Jewett M. Impact of a multi-disciplinary patient education session on accrual to a difficult clinical trial: the Toronto experience with the surgical prostatectomy versus interstitial radiation intervention trial. J Clin Oncol 2006;24:41584162.

    • Search Google Scholar
    • Export Citation
  • 14.

    Gross CP, Herrin J, Wong N. Enrolling older persons in cancer trials: the effect of sociodemographic, protocol, and recruitment center characteristics. J Clin Oncol 2005;23:47554763.

    • Search Google Scholar
    • Export Citation
  • 15.

    Smith AW, Reeve BB, Bellizzi KM. Cancer, comorbidities, and health-related quality of life of older adults. Health Care Financ Rev 2008;29:4156.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 146 116 14
PDF Downloads 16 15 1
EPUB Downloads 0 0 0