Lauren P Knelson1, Anthony R Cukras2, Jennifer Savoie1, Ankit Agarwal3, Hao Guo4, Jiani Hu4, Geoffrey Fell4, Ruth Lederman1, Melissa E Hughes1, Eric P Winer1, Nancy U Lin5, Sara M Tolaney6. 1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. 2. Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA. 3. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC. 4. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA. 5. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. Electronic address: Nancy_Lin@dfci.harvard.edu. 6. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. Electronic address: Sara_Tolaney@dfci.harvard.edu.
Abstract
BACKGROUND: Only a small proportion of patients with cancer enroll onto clinical trials. Previous studies have explored patient-related barriers to trial participation; however, few studies have focused on the provider perspective. We aimed to describe referral practices and barriers to referrals of patients with breast cancer for clinical trials, including the utilization of web-based trial-matching tools. MATERIALS AND METHODS: In 2016, we distributed 120 surveys to attendees of a breast oncology continuing medical education course. The survey addressed referral patterns, trial knowledge, and perceptions of web-based trial-matching tools. After survey completion, participants were provided a link to the Dana-Farber Cancer Institute trial-matching tool. Three months later, a follow-up survey was sent to assess their use of this tool. Descriptive statistics were used to summarize survey data. RESULTS: Ninety-six (80%) participants completed the first survey; 5 respondents did not actively treat patients with breast cancer and were excluded. Respondents included medical (30%) and surgical (22%) oncologists, nurse practitioners/physician assistants (26%), and other (22%). Neoadjuvant and metastatic trials were deemed the highest priority. The primary reported barriers included perceived lack of patient interest, lack of trial awareness, and logistical barriers. Emailing trial investigators directly was the preferred method of trial referral. Although 80% indicated that web-based tools would increase trial referrals, our follow-up survey revealed that only 18% of respondents used our web-based tool. CONCLUSION: Our respondents valued trial participation for their patients but found it difficult to manage. Further research is needed regarding how to increase the likelihood that patients are presented with appropriate trial options.
BACKGROUND: Only a small proportion of patients with cancer enroll onto clinical trials. Previous studies have explored patient-related barriers to trial participation; however, few studies have focused on the provider perspective. We aimed to describe referral practices and barriers to referrals of patients with breast cancer for clinical trials, including the utilization of web-based trial-matching tools. MATERIALS AND METHODS: In 2016, we distributed 120 surveys to attendees of a breast oncology continuing medical education course. The survey addressed referral patterns, trial knowledge, and perceptions of web-based trial-matching tools. After survey completion, participants were provided a link to the Dana-Farber Cancer Institute trial-matching tool. Three months later, a follow-up survey was sent to assess their use of this tool. Descriptive statistics were used to summarize survey data. RESULTS: Ninety-six (80%) participants completed the first survey; 5 respondents did not actively treat patients with breast cancer and were excluded. Respondents included medical (30%) and surgical (22%) oncologists, nurse practitioners/physician assistants (26%), and other (22%). Neoadjuvant and metastatic trials were deemed the highest priority. The primary reported barriers included perceived lack of patient interest, lack of trial awareness, and logistical barriers. Emailing trial investigators directly was the preferred method of trial referral. Although 80% indicated that web-based tools would increase trial referrals, our follow-up survey revealed that only 18% of respondents used our web-based tool. CONCLUSION: Our respondents valued trial participation for their patients but found it difficult to manage. Further research is needed regarding how to increase the likelihood that patients are presented with appropriate trial options.