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Understanding and facilitating clinical research in melanoma

August 31, 2017

Michelle Wilson

Clinical Trials

[Please note that Paul O'Neil is my co-author and co-presenter]

Cancer remains the leading cause of mortality in New Zealand and is likely to be the defining health issue for the next decade. Clinical trials are designed to improve patient outcomes with the ultimate global priority to reduce cancer related morbidity and mortality. Importantly, they offer access to new therapies and have been shown to impact patient outcomes. Despite the recognition of their importance, less than 5% of adult patients with cancer are involved in clinical trials.

In contrast, over 60% of children with cancer in the United States are enrolled in clinical trials.1 Survival rates in paediatric tumours has quadrupled over the past four decades driven by the introduction of new therapies as a consequence of the high rate of clinician and patient involvement in research.1 This model allows for rapid evaluation of new therapies, and delineation of the sub-populations that do benefit.1

 Multiple barriers to enrolment in clinical trials have been recognised including patient, clinician and institutional factors. Key factors include paucity of trials, cost (financial and time), belief in the study, age and comorbidities.2-4 While it is important for us to draw on the experience from other countries, we need to understand the barriers relevant to our patient population and health care system. This will help us implement strategies relevant to our patients and systems.   

This session will explore the barriers to clinical trials in New Zealand focussing on melanoma. Patients’ experiences and perspectives on clinical trials will be discussed. We will explore overseas models and consider the relevance of these to our patients in New Zealand. Ultimately, this session aims to develop a model for the conduct of clinical research in melanoma in New Zealand to improve equity and opportunities at a national level.  

REFERENCES

1.         Gelijns AC, Gabriel SE. Looking beyond translation--integrating clinical research with medical practice. The New England journal of medicine 2012;366:1659-61.

2.         Ross S, Grant A, Counsell C, Gillespie W, Russell I, Prescott R. Barriers to participation in randomised controlled trials: a systematic review. Journal of clinical epidemiology 1999;52:1143-56.

3.         Townsley CA, Selby R, Siu LL. Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2005;23:3112-24.

4.         Tournoux C, Katsahian S, Chevret S, Levy V. Factors influencing inclusion of patients with malignancies in clinical trials. Cancer 2006;106:258-70.



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