Association between self-reported breast cancer knowledge and clinical trial participation in patients with...

Patients with triple-negative breast cancer (TNBC) are encouraged to consider clinical trials given limited treatment options, yet little is known regarding barriers to trial participation in this population. We examined whether patient-level factors, including disease knowledge, were associated with TNBC patients' participation in trials.

From a prospective multicenter registry of patients with newly-diagnosed TNBC, we identified those with stage I-III tumors who completed at least one survey assessing TNBC knowledge, risk perceptions, treatment rationales, and participation in trials. Accuracy of tumor characteristics reported by patients was verified with medical records. Logistic regression was used to identify factors associated with self-reported trial participation.

TNBC knowledge varied among patients, with many reporting their tumor characteristics incorrectly and/or underestimating their recurrence risk. Among 116 patients with trial participation responses, 55 (47%) reported participating in a trial, including 35% who underwent upfront surgery and 66% who received neoadjuvant systemic therapy. Trial participation was less likely in upfront surgery patients (odds ratio [OR]: 0.41, 95% confidence interval [CI]: 0.20-0.89, p = 0.02) and more likely in stage II versus stage I patients (OR: 2.43, 95% CI: 1.09-5.39; p = 0.03). No associations were found with TNBC knowledge.

Nearly half of patients surveyed reported participating in trials. While not significantly associated with trial participation, many patients demonstrated limited knowledge about TNBC and their prognosis. More research is needed to understand trial participation barriers and improve information delivery in this population to leverage patient engagement in developing more effective TNBC treatments.