Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA.
Clin Breast Cancer. 2020 Oct;20(5):395-401.e3. doi: 10.1016/j.clbc.2020.05.001. Epub 2020 May 7.
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.
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.
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.
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.
只有一小部分癌症患者参加临床试验。先前的研究已经探讨了患者参与试验的相关障碍；然而，很少有研究关注提供者的观点。我们旨在描述将乳腺癌患者转介参加临床试验的做法和障碍，包括利用基于网络的试验匹配工具。
2016 年，我们向参加乳腺癌继续教育课程的与会者分发了 120 份调查问卷。该调查涉及转诊模式、试验知识以及对基于网络的试验匹配工具的看法。完成调查后，参与者将获得丹娜-法伯癌症研究所试验匹配工具的链接。三个月后，发送了一份后续调查，以评估他们对该工具的使用情况。使用描述性统计来总结调查数据。
96 名（80%）参与者完成了第一次调查；5 名受访者未积极治疗乳腺癌患者，因此被排除在外。受访者包括医学（30%）和外科（22%）肿瘤学家、护士从业者/医师助理（26%）和其他（22%）。新辅助和转移性试验被认为是最高优先级。主要报告的障碍包括认为患者缺乏兴趣、缺乏试验意识和后勤障碍。直接向试验研究者发电子邮件是转诊的首选方法。尽管 80%的人表示基于网络的工具将增加试验转诊，但我们的后续调查显示，只有 18%的受访者使用了我们的基于网络的工具。
我们的受访者重视为患者参与试验，但发现难以管理。需要进一步研究如何增加向患者提供适当试验选择的可能性。
