Introduction: Under-enrollment in clinical trials significantly limits valid analyses of clinical interventions and generalizability of findings. It can also result in premature study termination, with estimates of 22% and 50% of clinical trials being terminated due to poor accrual. Currently, there are limited reports addressing socioeconomic factors influencing clinical trial enrollment in neuro-oncologic. The goal of this study was to determine if patient demographics such as insurance status, race/ethnicity, gender, and age impacts clinical trial enrollment.
Methods: A search within the UCSF Tumor Board Registry identified 1436 adult patients discussed over an 18-month period. This cohort was analyzed to determine the rate of clinical trial enrollment based on clinical reports available through the electronic medical record.
Results: 152 patients (10.6%) were recommended for clinical trial based on tumor board review of clinical status, prior treatment history, and pathology. Of these, 80 patients (52.6%) proceeded with enrollment in a trial. 22% of the study population belonged to a NIH designated minority group. Patient and disease factors associated with clinical trial enrollment included WHO grade (p<0.05) and insurance status (p<0.05). When analyzing all NIH designated minority populations, the rate of recommendation for a clinical trial enrollment did not differ compared to the non-minority cohort. Factors such as age, gender, race or distance from the medical center was not different among the patients who were recommended for clinical trial participation versus those who were not. Patient decision to proceed with clinical trial enrollment was impacted only by distance to the medical center (p<0.05).
Conclusions: These results suggest that in neuro-oncology, tumor board recommendation for clinical trial enrollment may be influenced by both patient and oncological factors. Such results provide insight into barriers to patient enrollment in appropriate trials.
Patient Care: These results suggest that tumor board recommendations for a clinical trial may be influenced by patient demographic factors. Such results provide insight into barriers to patient enrollment in appropriate trials.This may provide future avenues to increase clinical trial enrollment.
Learning Objectives: 1. Describe the rate of clinical trial recommendation and actual enrollment for patients discussed at an academic center tumor board
2. Highlight patient demographic factors associated with clinical trial recommendation
3. Highlight patient demographic factors associated with actual clinical trial enrollment