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Patients' selection and trial matching in early-phase oncology clinical trials
P Corbaux1, A Bayle2, S Besle3
1Medical Oncology Department, Centre Léon Bérard, Lyon, France; Medical Oncology, Institut de Cancérologie et d'Hématologie Universitaire de Saint-Étienne (ICHUSE), Centre Hospitalier Universitaire de Saint-Etienne, France.
Background:
Early-phase clinical trials (EPCT) represent an important part of innovations in medical oncology and a valuable therapeutic option for patients with metastatic cancers, particularly in the era of precision medicine. Nevertheless, adult patients' participation in oncology clinical trials is low, ranging from 2% to 8% worldwide, with unequal access, and up to 40% risk of early discontinuation in EPCT, mostly due to cancer-related complications.
Design:
We review the tools and initiatives to increase patients' orientation and access to early phase cancer clinical trials, and to limit early discontinuation.
Results:
New approaches to optimize the early-phase clinical trial referring process in oncology include automatic trial matching, tools to facilitate the estimation of patients' prognostic and/or to better predict patients' eligibility to clinical trials. Classical and innovative approaches should be associated to double patient recruitment, improve clinical trial enrollment experience and reduce early discontinuation rates.
Conclusions:
Whereas EPCT are essential for patients to access the latest medical innovations in oncology, offering the appropriate trial when it is relevant for patients should increase by organizational and technological innovations. The oncologic community will need to closely monitor their performance, portability and simplicity for implementation in daily clinical practice.
Insights
Improving early-phase cancer clinical trials (EPCT) access and reducing early discontinuation is crucial for patients seeking innovative oncology treatments. Technological and organizational advancements can enhance patient recruitment and trial experience.
Area of Science:
- Oncology
- Clinical Trials
- Precision Medicine
Background:
- Early-phase clinical trials (EPCT) are vital for medical innovation in oncology.
- Patient participation in oncology trials is low (2-8%) with unequal access.
- EPCT face high discontinuation rates (up to 40%) due to cancer progression.
Purpose of the Study:
- To review strategies for increasing patient access to early-phase cancer clinical trials.
- To identify methods for reducing early discontinuation in these trials.
Main Methods:
- Review of existing tools and initiatives.
- Analysis of approaches to optimize trial referral and patient matching.
Main Results:
- Optimized referral processes include automatic trial matching and predictive eligibility tools.
- Combining classical and innovative approaches can double recruitment and improve enrollment experience.
- These strategies aim to reduce early discontinuation rates.
Conclusions:
- Organizational and technological innovations are needed to improve patient access to relevant oncology trials.
- The oncologic community must monitor the performance, portability, and simplicity of these innovations for clinical practice.
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