Monday, August 3, 2009

Cancer Clinical Trial Volunteers Essential To Finding A Cure

The New York Times' Gina Kolata continues her excellent series about cancer, Forty Years' War, highlighting the difficult task of enrolling patients in clinical trials for new cancer therapies.

Lack of Study Volunteers Hobbles Cancer Fight

Not long ago, at a meeting of an advisory group established by Congress to monitor the war on cancer, participants were asked how to speed progress.

“Everyone was talking about expanding the cancer work force and getting people to stop smoking,” said Dr. Scott Ramsey, a cancer researcher and health economist, who was participating in that January 2008 meeting of the President’s Cancer Panel. “Lots of murmurs of approval.”

Then it was his turn.

The biggest barrier, in his opinion, was that almost no adult cancer patients — just 3 percent — participate in studies of cancer treatments, mostly new drugs or drug regimens.

“To me it was obvious,” Dr. Ramsey said. “We can’t improve survival unless we test new treatments against established ones.”

The room fell silent.

“It was one of those embarrassing moments,” said Dr. Ramsey, an associate professor at the Fred Hutchinson Cancer Center in Seattle. He had brought up the subject he said no one wanted to touch.

Low enrollment rates for clinical trials is disappointing, but more so is the fact that many trials that enroll patients do little to advance the search for cures...

Even worse, many (clinical trials) that do get under way are pretty much useless, even as they suck up few patients willing to participate. These trials tend to be small ones, at single medical centers. They may be aimed at polishing a doctor’s résumé or making a center seem at the vanguard of cancer care. But they are designed only to be “exploratory,” meaning that there are too few patients to draw conclusions or that their design is less than rigorous.

“Unfortunately, many patients who are well intentioned are in trials that really don’t advance the field very much,” said Dr. Richard Schilsky, an oncologist at the University of Chicago and immediate past president of the American Society of Clinical Oncology.

Refreshing honesty.

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