how you can be an advocate for clinical trials in your community
TRANSCRIPT
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Objectives
Define cancer clinical trials, including how they work and their risks and benefits
Identify common patient barriers to participation in cancer clinical trials
Discuss barriers faced by health-care providers to making referrals, and explore ways in which these barriers can be overcome
Name at least two sources of additional information about clinical trials
Identify at least two key messages about cancer clinical trials that you can share with peers
Why Should We Care About Cancer Clinical Trials?We all benefit from finding better ways to treat or prevent cancer
Cancer Clinical Trials…
Are research studies to find better ways to prevent, detect, or treat cancer
Help doctors find ways to improve cancer care
Who Benefits?
Less than 5% of all adults with cancer participate in clinical trials
And, even fewer among racial and ethnic minority and low-income groups
The results of many trials help change the way cancer care is provided for everyone, but…
Some Are More Likely to Die from Cancer than Others
* Hispanic is not mutually exclusive from whites, African Americans, Asian/Pacific Islanders, and American Indians/Alaska Natives.SEER Program, 1975–2002, Division of Cancer Control and Population Sciences, National Cancer Institute (2005)
There’s a Lot of Myths About Cancer Research
Only the researchers benefit!
You get a sugar
pill.
Not the way for people like
me to get good care!
It’s a treatment of last resort!! They treat
you like a “guinea
pig”
Do Patients Get a Placebo?
In cancer treatment trials, people get treated for their cancerNo one gets a placebo (sugar pill)
instead of appropriate treatment Placebos may be used in prevention
trials
Reasons Why People Don’t Participate in Clinical Trials
Don’t trust “the system” Believe the myths Aren’t aware Have a different cultural
perspective Don’t qualify Don’t have insurance Face other problems
More Reasons Why People Don’t Participate in Clinical Trials
Community doctors (primary care)
Aren’t aware
Don’t refer patients to clinical trials
Participating doctors (oncologists)
May not ask all patients who are eligible
There Are Different Types of Cancer Clinical Trials Treatment
Prevention
Diagnostic
Screening/early detection
Quality of life
Three Phases of Clinical Trials Phase I: is it safe? Phase II: does it work? Phase III: is it better than what is used
now to treat this cancer?
1. Preclinical research
2. File Investigational New Drug Application with FDA
6. File New Drug Application or Biologics License Application with FDA
3. Phase I
4. Phase II
5. Phase III
7. Review by FDA and approval
8. Postmarketing surveillance
In Many Clinical Trials, Participants Are Placed into Different Groups
One group gets the most widely accepted treatment
The other group(s) gets the new treatment being tested, which doctors hope will be better
All participants in the trial have an equal chance to be assigned to one of two or more groups:
There Are Benefits …
In most trials, patients get at least the best treatment available
Patients are closely followed by doctors and nurses
If the new treatment is proven to work, patients may be among the first to benefit
… And There Are Risks
Even if a new treatment has benefits, it may not work for all patients
New treatments are not always better than what is already being used to treat the cancer
There may be unexpected side effects
Other Concerns
Clinical trials may have added costs that aren’t covered by insurance
Not everyone is able to join a clinical trial
There Are Laws Protecting Patients’ SafetyFederal regulations
ensure that people are told about the benefits, risks, and purpose of research before they agree to participate
We Have Protections Today Because of Abuses in the Past
In German concentration camps
In the Tuskegee Syphilis Study
With retarded children and with the elderly
20th Century abuses of human rights…
Protections Today: Informed Consent Process
The purpose of the trial What will happen during
the trial The risks and potential
benefits Their individual rights
Participants must be told about…
Protections Today: Three Other Ways
Scientific review Institutional
Review Boards (IRBs)
Data Safety Monitoring Boards(DSMBs)
How Would You Respond?
Patients never get a placebo (sugar pill) instead of appropriate treatment
They have rights that are protected under the law
They also have the right to leave a clinical trial at any time, for any reason
Aren't people who join cancer
clinical trials just "guinea
pigs" for research?
How Would You Respond?
Clinical trials are not only for those with the most advanced disease
Clinical trials can be a good treatment option for many types of cancer patients
They are not the “last resort” for patients who have no other treatment choices
Cancer treatment
clinical trials are the
treatment of “last resort.”
Levels of Cancer Clinical Trials: Awareness and Acceptance
Not aware of cancer clinical trials
General “awareness” of cancer clinical trials
» Looking for options for treatment, not aware
» Exploring clinical trials
» Actively participating in a cancer clinical trial
» Past participant of a cancer clinical trial
General public Cancer patient
Things You Can Share with Anyone About Cancer Clinical Trials
Cancer clinical trials are studies with people looking at ways to better prevent, diagnose, and treat cancer
The only way we can make progress in fighting cancer is through clinical trials
Most people with cancer aren’t told that clinical trials are a quality treatment option
More Things You Can Share with Anyone About Cancer Clinical Trials Taking part is voluntary, and participants
can leave the clinical trial at any time There are federal laws that protect the
rights of research participants Clinical trials are not appropriate for
everyone
4 Things You Can Share About Cancer Clinical Trials with Every Patient
Ask your doctor about all your treatment options, including clinical trials
Patients on cancer clinical trials receive high quality care
All patients get treated for their cancer No one gets a placebo (sugar pill)
instead of appropriate treatment
Ask, Assess, Assist
Offer appropriate information and support about cancer clinical trials
Adapted from Tobacco Cessation 5. A Model Clinical Practice Guideline: Treating Tobacco Use and Dependence.
Ask
» Assess where they stand in terms of awareness level to reply appropriately
» Ask open questions to help understand someone’s current knowledge and attitudes about clinical trials
Assess
Assist
How Would You Respond? Julie, a fellow co-worker, joins you at the
office cafeteria for lunch. As you both sit down, Julie picks up the local newspaper on the table and runs across an article reporting findings from a recent breast cancer treatment trial. She turns to you, commenting ,“I’d never want to be on one of these trials if I had cancer. That’s only for people as a last resort.”
Three Things You Can Do
Practice talking about cancer clinical trials with family and friends
Look for recent examples about clinical trials in the media as a means of initiating a conversation
Share what you’ve learned today with your fellow cancer advocates and how you can make cancer clinical trials education more of a priority within the services you provide