ASCO 2019: Barriers to Accrual and Enrollment in Brain Tumor Trials

A major impediment to improving brain tumor outcomes is poor clinical trial accrual. In fact, only 20 percent of neuro-oncology patients enroll in clinical trials. Surveys of brain tumor patients and neuro-oncology providers suggest that clinicians do a poor job of discussing clinical trials with patients and referring patients for clinical trials. Yet, data from the Cancer Action Network of the American Cancer Society suggest that when most eligible oncology patients are asked to enroll in a clinical trial, they will agree to do so.

Only 20 percent of neuro-oncology patients enroll in clinical trials.

The Society for Neuro-Oncology (SNO) in collaboration with the Response Assessment in Neuro-Oncology (RANO) Working Group, patient advocacy groups including the American Brain Tumor Association, clinical trial cooperative groups including the Adult Brain Tumor Consortium (ABTC), and other partners are working together with the intent to double clinical trial accrual over the next five years.

This collaborative group reviewed the literature and held several working group calls to discuss the barriers to clinical trial accrual as well as potential solutions to decreasing these barriers to participation in brain tumor clinical trials.

Some of those solutions include:

  • Support research to better define factors specifically affecting neuro-oncology accrual
  • More systematic documentation of reasons for why patients do not enroll in trials
  • Provider and patient educational campaigns as well as engagement with advocacy groups to change the mindset that clinical trials are only a last resort to the mindset that it is the best option for most patients
  • Use of modern technology including social media, apps, Internet-based clinical trial matching programs to help spread information about trials
  • Creation of national brain tumor registries
  • Expand clinical trial opportunities in the community setting
  • Any patient with a GBM or uncommon brain cancer should be offered a referral to a major neuro-oncology center(s) in their relative proximity for consideration of clinical trials
  • Modernize clinical trial design and eligibility (an active effort)

This data was recently accepted for publication in the journal of Neuro-Oncology. The abstract for the article can be accessed here.


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