In a Japanese study reported in JAMA Network Open, Uehara et al found that travel time to the National Cancer Center Hospital (NCCH) in Tokyo affected the participation of referred patients with cancer in genotype-matched clinical trials.
Study Details
The retrospective cohort study, performed between June 2020 and June 2022, included 1,127 patients referred to the NCCH for participation in genotype-matched trials following comprehensive genomic profiling and discussion by molecular tumor boards.
Key Findings
Among the 1,127 referred patients, 127 (11%) were enrolled in genotype-matched trials and 241 (21%) were enrolled in all-cancer (genotype-matched and genotype-nonmatched) trials.
Overall, the median travel distance and time to NCCH were 38 km, or about 24 miles (interquartile range [IQR] = 21–107 km) and 55 minutes (IQR = 35–110 minutes).
In this cohort study of patients undergoing comprehensive genomic profiling testing, an increased travel time was associated with a decreased likelihood of genotype-matched trial participation. This warrants further research on interventions, such as decentralization of clinical trials to mitigate travel burden.— Uehara et al
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On multivariate analysis, a travel distance of ≥ 100 km vs < 100 km was not significantly associated with likelihood of genotype-matched trial participation; participation rates were 8% (26 of 310 patients) vs 12% (101 of 807 patients), with an odds ratio of 0.64 (95% confidence interval [CI] = 0.40–1.02).
On multivariate analysis, genotype-matched trial participation was significantly less likely among patients with a travel time of ≥ 120 minutes vs < 120 minutes; participation rates were 7% (19 of 276 patients) vs 13% (108 of 851 patients), with an odds ratio of 0.51 (95% CI = 0.29–0.84). The likelihood of genotype-matched trial participation decreased as travel time increased from < 40 minutes (38 of 283 patients = 13%) to between 40 and 120 minutes (70 of 568 patients = 12%; odds ratio [OR] = 0.74, 95% CI = 0.48–1.17) and to ≥ 120 minutes (19 of 276 patients = 7%; OR = 0.41, 95% CI = 0.22–0.74).
Travel time and duration were not significantly associated with all-cancer clinical trial participation.
The investigators concluded, “In this cohort study of patients undergoing comprehensive genomic profiling testing, an increased travel time was associated with a decreased likelihood of genotype-matched trial participation. This warrants further research on interventions, such as decentralization of clinical trials to mitigate travel burden.”
Takafumi Koyama, MD, PhD, of the Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, is the corresponding author for the JAMA Network Open article.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
