What are CCTs, and Why do they Matter?
Cancer clinical trials, or CCTs, are research studies that involve humans. They give physicians and researchers data to help improve cancer treatments, find and diagnose cancer, prevent cancer, and manage cancer treatment and treatment side effects. Most importantly, CCTs translate scientific discoveries into eventual standards of care, or the diagnostic and/or treatment standard a physician should follow when treating patients.
For patients who just a few years ago faced poorer prognoses, CCTs continuously push the boundaries for improving life-saving cancer treatments, which means lower mortality and less suffering for patients overall. As enrollment and participation in CCTs increases, researchers discover, test, and utilize new treatment and diagnostic methods.
Why do Clinical Trials Need Fixing?
Unfortunately, there are a few critical problems that CCTs face today. The first is participation: did you know that only 2-5% of cancer patients enroll in clinical trials? This is despite studies showing that most cancer patients are open to enrolling: a 2003 paper in JCO by Comis et al., found that, "approximately 32% of American adults (64 million individuals) indicate that they would be very willing to participate in a cancer clinical trial if asked to do so. An additional 38% of adults (76 million individuals) scored in a range that indicates that they are inclined to participate in a cancer clinical trial if asked, but hold some questions or reservations about participation." Another common issue is completion of trials: 70% of CCTs are delayed, and 25% never even reach their enrollment goals.
Many cancer patients are also left in the dark about clinical trials, because they frequently are not informed by their physicians about CCTs they may be eligible to participate in. This is due to many factors: physician preference for a particular treatment, concern that a trial result will negatively affect the patient-physician relationship, and even fears that a physician's patient would be given a placebo during the trial.
The bottom line? Critical questions that CCTs are asking go completely unanswered.
What Does theMednet Platform and Q&A Model have to do with Improving Clinical Trial Enrollment?
theMednet is changing the way physicians learn about cancer clinical trials. We know that physician awareness of a trial, their knowledge of patient eligibility, and their ease of discussing the trial as a treatment option are the three most vital factors that influence patients' enrollment.
In 2018, theMednet partnered with SWOG to raise awareness to CCTs among SWOG members. The study asked SWOG investigators about their awareness of trials that were open at their own institutions. For one SWOG trial (S1418), 47% of investigators were unaware of the trial, although 76% were interested in learning about it. For another SWOG trial (S1507), 68% were unaware of the existence of the trial open at their own institutions! When physicians are not aware of these important trials, patients lost out on vital CCT benefits. theMednet conducted a targeted and personalized campaign aimed at increasing physician awareness and enrollment for these trials by utilizing ads on our site, Q&A referencing the trials, direct messaging from the PI, and social and interactive enrollment leaderboards.
The results were more than promising: for one, we exceeded our registration goal for physicians to theMednet by 150%. Awareness of the two trials increased by 14.5% on average, and a number of physicians reported learning about trials that they did not previously know about. The SWOG investigators also indicated they wanted to receive more personal messages about upcoming trials.
Having learned that these social ways of learning about clinical trials improve physician awareness, we shifted our focus to technology. We asked, what if we could start suggesting clinical trials based on physicians' questions? Could we raise awareness trials at the pivotal moment that a physician is just trying to figure out how to treat their patient? theMednet worked with machine learning experts at Yale University to do just that. You can learn about our National Science Foundation funded research in this talk given at the NCI Data Science Workshop here.