Two-thirds of Americans shun clinical drug trials: survey

Just over one-third of Americans are willing to participate in a clinical trial, and more than half of doctors do not consider recommending clinical trials until later in treatment, according to a recent survey.

Researchers at Memorial Sloan Kettering Cancer Center, which has nearly 1,000 clinical trials currently underway, found that the difficulty enrolling patients in trials for new drugs is based on the misconceptions of patients and apprehension of doctors.

 Before drugs are brought to market, they go through often exhaustive clinical trials to test efficacy against disease and find potential side effects.

Patients are in equal parts nervous about trying an unproven drug and being given a placebo, which means they will not actually be treated, but when educated briefly on trials - such as that most cancer drug trials do not involve placebo groups - their opinion improved significantly.

"Failing to consider clinical trials at every stage of cancer diagnosis and treatment can represent a significant missed opportunity, primarily for patients, as well as for doctors and researchers trying to develop better therapies," Dr Paul Sabbatini, depute physician-in-chief for clinical research at Memorial Sloan-Kettering Cancer Center, said in a press release.

"It's critical that we spread the word: clinical trials offer our best thinking toward finding better ways to prevent, treat, and cure cancer, and there are options for patients and their families to consider early on in treatment."

For the survey, researchers for Sloan Kettering interviewed 1,511 healthcare consumers between age 18 and 69, as well as 594 doctors who have discussed clinical trials with their patients.

The researchers found 35 per cent of consumers are "likely" to enrol in a clinical trial, and just 40 per cent have an overall positive view of trials.

Among consumers hesitant to participate in a trial, 55 per cent are worried about side effects and safety, 50 per cent are uncertain about insurance or out-of-pocket costs, 48 per cent found trial locations are inconvenient, 46 per cent worried about getting a placebo, 35 per cent were concerned about drug treatments not proven to be effective and 34 per cent did not want to feel like a guinea pig.

Doctors share some concerns with their patients about trials, with 56 per cent saying they do not consider them until late in treatment and 28 per cent calling them a "last resort" option. Just under one-third, 32 per cent, of doctors said they discuss trials that could potentially help their patients at the beginning of treatment.

Among doctors, 63 per cent were concerned about safety in trials, 63 per cent were worried about patients receiving placebo rather than treatment and 53 per cent were worried their patients would feel like guinea pigs.

"When it comes to advancing cancer care, clinical research is the rocket fuel for better treatments, more accurate diagnoses, and, ultimately, cures," said Dr José Baselga, physician-in-chief and chief medical officer at Sloan Kettering. "If this trend of low enrolment continues, we will face a crisis in cancer research and discovery. Further education is the key to participation and progress."