What are the greatest challenges in the use of clinical trials as a treatment option for pancreatic cancer? Are patients interested and willing to try an investigational therapeutic approach?

FAQ Library published on October 17, 2014 in Clinical Trials
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Vincent Picozzi, Jr., MD, MMM
Director
Pancreatic Center of Excellence
Digestive Disease Institute
Virginia Mason Medical Center
Seattle, Washington
What are the greatest challenges in the use of clinical trials as a treatment option for pancreatic cancer? Are patients interested and willing to try an investigational therapeutic approach?
My name is Dr. Vince Picozzi, and I am a medical oncologist with the special interest in pancreatic cancer here at the Virginia Mason Clinic in Seattle, Washington. I am also the director of the Center of Excellence for Pancreas Disease here at Virginia Mason. I am frequently asked, “What are the greatest challenges in use of clinical trials as a treatment option for pancreatic cancer, and furthermore, are patients are interested and willing to try an investigative therapeutic approach?” Let me start with the second question, that is an easy one. There was a study that was done by the Pancreatic Cancer Action Network published in a prominent oncology journal last year, and in that paper, approximately two-thirds of patients expressed an interest in clinical trials. Despite that, only about 4.5% of patients actually enrolled in the clinical trial, so there is a tremendous interest in clinical trials among patients and families with pancreatic cancer. Now, why is it that two-thirds of patients are interested, but only about 4% of patients enroll? Well, I think there are many reasons for this, but I think three in particular are important. The first is that there are many areas and many types of patients for whom clinical trials unfortunately do not exist either because of geography, because of disease stage, and because of particulars about the trial itself. Unfortunately, the trials that we have do not always encompass the full groups of patients that are interested. A second important reason is that treatment can sometimes begin before a clinical trial is considered, and so a take-home message there for patients and their families are be sure to ask your oncologist, be sure to ask your doctor at the very first clinical visit about clinical trials availability if indeed you are interested. The third reason which may be the biggest reason is unfortunately an aura of pessimism and negativism still permeates management of pancreatic cancer, sad to say sometimes among doctors. Some doctors believe treating pancreas cancer is a feudal effort, that clinical trials are not of use, and so they are not enamored with their application, and so therefore, clinical trial involvement is not as widespread as we would hope. So, again, if we take these three challenges, appropriate trials available, receiving treatment for a trial can be considered, and attitude, it is very important that patients find a doctor partner who embraces the concept of clinical trials, and will make them available to them either at their own treatment site or elsewhere. So, with that, I thank you for viewing this activity and for additional resources please be sure to view our other educational activities on our PartnersinPancreaticCancer.com.
Last modified: August 12, 2014
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