What if discussing clinical trials opportunities were a standard part of patient care? This question spurred discussion among members of a diverse panel at a recent Coalition for Clinical Trials Awareness roundtable event. Panelists included:
- David Charles, MD, Steering Committee Chairman, Coalition for Clinical Trials Awareness
- Robert Popovian, Senior Director of US Government Relations, Pfizer Pharmaceuticals
- Marci Reeder, Executive Director, NCCN Foundation, National Comprehensive Cancer Network
- Ellen Sonet, Chief Strategy and Alliance Officer, CancerCare.
Panelists considered both the advantages and challenges of a health care system in which every patient would hear from his or her doctor about the potential to join a clinical trial.
Challenges
- Keeping physicians current. Physicians should talk with their patients about clinical trials, Dr. Charles acknowledged, but the prospect is complicated. “Practically, how does that work?,” Dr. Charles asked, “How does a community physician keep abreast of what’s going on in clinical trials?” Dr. Charles described his own experiences at an academic research center, acknowledging that if he were asked by patients for information about a trial outside his own department, “I would struggle.”
- Overcoming financial disincentives. Physicians who are not involved in clinical trials may hesitate to relinquish care for their patients. Financial disincentives may also exist under the current cancer care system, where in-office treatments such as chemotherapy provide a revenue stream that would be cut off if patients left the practice for a clinical trial.
As Ellen Sonet explained, some patients “are not presented with trial options, especially if those options are not available from the clinician who is beginning to treat them.”
- Providing tools to direct and inform. “ClinicalTrials.gov was never meant to be a portal for patients or physicians to find clinical trials,” explained Robert Popovian. “We need a ClinicalTrials.gov 2.0 that includes a lot of materials that physicians and patients can easily navigate and use to identify appropriate opportunities” he explained, “Where a patient can go in and say, ‘I have diabetes, I’m at this age, this gender, this is my number of years on the multiple medicines I’m on’ and ‘Boom’ out pops clinical trials that are available in their geographical area.”
Benefits
- Giving patients the information they lack. “You can’t enroll in a clinical trial if you don’t know about it,” Ellen Sonet explained. Making a conversation about clinical trials part of standard of care would ensure that patients have an awareness they currently lack. It could also ensure that the treatment decisions they make are fully informed.
- Allowing for first-rate care. Marci Reeder explained that, “Clinical trial participation is…fantastic care, the latest breakthrough in potential therapies. Patients get followed very closely and you usually have wonderful, wonderful experiences.” Patients who lack awareness about clinical trials in general or information about specific opportunities can miss out on the high level of care these experiences often provide.
- Increasing enrollment & encouraging breakthrough therapies. All participants agreed on a fundamental irony: though clinical trials enrollment lags, patients and their families often struggle to find information about clinical trials that they could join. Making a clinical trials conversation standard could help bridge that gap, improving enrollment for trials that can ultimately bring to market new medications, devices and diagnostics for patients across the globe. “No matter which [patient advocacy] organization you talk to,” Marci Reeder acknowledged, “clinical trials is the one topic we all agree on.”
To learn more about the Coalition for Clinical Trials Awareness and the need for greater enrollment in clinical trials, visit www.CCTAwareness.org.
