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Risks and benefits of phase 1 clinical trial participation
1Clinical Research Unit, Moffitt Cancer Center, Tampa, FL 33612, USA. Amit.Mahipal@Moffitt.org.
Background:
The results from phase 1 clinical trials can allow new treatments to progress further in drug development or halt that process altogether. At the forefront of phase 1 clinical trials is the safety of every patient participant, which is particularly true when testing new oncologic treatments in which patients may risk potentially toxic treatments in the hope of slowing the progression of or even curing their disease.
Methods:
We explore the benefits and risks that patients experience when participating in phase 1 clinical trials.
Results:
Rules and regulations have been put into place to protect the safety and interests of patients while undergoing clinical trials. Selecting patients with cancer who will survive long enough to accrue data for these trials continues to be challenging. New prognostic models have been validated to help health care professionals select those patients who will likely benefit from participation in phase 1 trials. There also are long-lasting positive and negative impacts on those patients who choose to participate in phase 1 clinical trials.
Conclusions:
Modern phase 1 clinical trials represent a therapeutic option for many patients who progress through frontline therapy for their malignancies. Recent phase 1 clinical trials testing targeted therapies have increased responses in many diseases in which other lines of therapy have failed. Patients still face many risks and benefits while enrolled in a phase 1 trial, but the likelihood of treatment response in the era of rational, targeted therapy is increased when compared with the era of cytotoxic therapy.
Insights
Phase 1 clinical trials offer cancer patients a therapeutic option, balancing potential benefits against risks. Modern targeted therapies in these trials show increased response rates compared to older cytotoxic treatments.
Area of Science:
- Oncology
- Clinical Pharmacology
- Drug Development
Background:
- Phase 1 clinical trials are critical for advancing new treatments, with patient safety as the primary concern, especially in oncology.
- Patients in oncologic trials may undergo potentially toxic treatments hoping for disease control or cure.
Purpose of the Study:
- To explore the benefits and risks encountered by patients participating in phase 1 clinical trials.
- To evaluate the evolving landscape of phase 1 trials in cancer treatment.
Main Methods:
- Review of existing literature and trial data concerning patient experiences in phase 1 clinical trials.
- Analysis of safety protocols and patient selection strategies.
Main Results:
- Protective regulations are in place, but patient selection for accrual remains challenging.
- Validated prognostic models aid in identifying patients likely to benefit from phase 1 trials.
- Participation has long-term positive and negative impacts on patients.
Conclusions:
- Phase 1 trials are a viable option for patients with advanced malignancies, particularly those who have failed prior therapies.
- Targeted therapies in modern phase 1 trials demonstrate improved response rates over traditional cytotoxic agents.
- Despite inherent risks, the potential for treatment response is enhanced with targeted therapies.
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