Cancer Research Lab

Misconceptions keep many patients from participating in lung cancer clinical trials, according to a report in the March Journal of Thoracic Oncology.

“Patients’ prior misperceptions about clinical trials (e.g., fear being offered a trial, assume placebo is a possibility, think they will wait to consider a trial if nothing else works, and over-confidence in standard treatment) often prevent them from making an informed decision in the first step — they automatically say no,” Dr. Gwendolyn P. Quinn from H. L. Moffitt Cancer Center and Research Institute, Tampa, Florida.

“Physicians can lead discussions about a clinical trial by dispelling common myths,” Dr. Quinn suggests.

Dr. Quinn and colleagues examined lung cancer patients’ knowledge, attitudes and behaviors regarding clinical trials for lung cancer in an effort to develop ways to increase patients’ knowledge and awareness of clinical trials. The investigators used a sample of 43 patients who underwent interviews.

New and existing patients expressed similar perceptions of clinical trials, including fear of being a “guinea pig,” the offer of a trial meant there was no hope, and misconception of purpose, the authors report.

Despite these perceptions, most respondents said they would still participate in a clinical trial if a physician offered one. Similarly, most former trial participants said they felt confident of their decision to participate in a clinical trial, the researchers note, even those whose health did not improve as a result of the trial.

Based on these interviews, the investigators created a letter to send to all new patients before their first appointment, explaining that offering a clinical trial at their hospital was the norm, to expect this discussion, and the option of standard treatment was also available.

After the introduction of this letter, lung cancer enrollment increased by 18% so that 81% of all eligible lung cancer patients were in a trial.

“Our next step involves creating a DVD for patients to watch either before their first appointment or as soon as they arrive in clinic,” Dr. Quinn said.

“The DVD will show the variety of patients who benefit from clinical trial participation (e.g., younger, newly diagnosed women, not just older white men) and emphasize that clinical trials are the norm at a research hospital and the offering of such should not be a cause of fear or concern to the patient but rather a source of hope.”

The second phase will be to identify the needs of caregivers of lung patients and to develop educational interventions to address these needs, Dr. Quinn explained. “Decisions about trials are typically not made alone, and caregivers need to know what to expect. When fears of the unknown are alleviated in advance, there may be greater support from family/caregivers for clinical trial participation.”