A portion of patients with cancer may be less likely to enroll in a clinical trial due to the ongoing coronavirus pandemic. According to a report published as a research letter by Mark E. Fleury, PhD, and colleagues in JAMA Oncology, nearly one in five patients with cancer surveyed said the pandemic would make them less likely to enroll in a trial. The top reason given for not enrolling was fear of COVID-19 exposure.
“While most patients would still be willing to take part in a clinical trial during the pandemic, the fear of COVID-19 exposure that would come with participating in a clinical trial is poised to cause many otherwise interested patients from enrolling. This means that trials that already struggled to find enough patients are likely to see reduced enrollment as long as the pandemic continues,” said Dr. Fleury, Principal of Policy Development and Emerging Science at the American Cancer Society Cancer Action Network (ACS CAN). “The barriers patients already faced pre-pandemic made it challenging to take part in clinical trials. Now, with the addition of COVID-19, it is even harder…. We're likely to see long-term impacts on the pace of research.”
"While most patients would still be willing to take part in a clinical trial during the pandemic, the fear of COVID-19 exposure that would come with participating in a clinical trial is poised to cause many otherwise interested patients from enrolling."— Mark E. Fleury, PhD
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Survey Findings
The finding was based on an ACS CAN survey of patients with cancer and survivors between late May and mid-June 2020.
Among the 192 survey respondents who were offered participation in a trial, 150 (78.1%) said yes and 116 (60.4%) eventually enrolled, resulting in an overall participation rate of 12.4%. Among 662 respondents not offered trial participation, 519 (78.4%) reported being somewhat or very likely to enroll if offered a trial.
All respondents were asked if the pandemic made them more or less likely to participate in a clinical trial. Among 907 respondents, nearly 80% indicated it made no difference; the remaining respondents were more than seven times more likely to indicate that the pandemic made them less likely to enroll in a clinical trial.
Later surveys showed COVID-19 anxiety remains high among patients, and fear of contracting the virus was cited—along with facility closures—as one of the main reasons patients delayed cancer care.
“The pandemic caused many institutions to stop enrolling new patients on clinical trials, and the assumption was that once facilities reopened, they could get enrollment back to normal. What we've found is that so long as the pandemic is still underway, fewer patients are going to volunteer for clinical trials,” said Dr. Fleury.
“The solution is that we need to get the pandemic under control or find innovative ways like telemedicine visits so that patients can take part in clinical trials without feeling exposed to additional COVID-19 risks.”
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
