Increasing volunteers: University researchers stress importance of clinical trials

Oncology researcher Paula Fracasso knows from personal experience how tough it can be to recruit patients for clinical trials.

Paula Fracasso
Paula Fracasso

When one of her close relatives was diagnosed with cancer, Fracasso, M.D., Ph.D., associate professor of medicine, spoke to her about enrolling in trials for new treatments for her cancer. She declined.

Fracasso was trying to impress upon her a reality often lost on the general public: If patients eligible for clinical trials for new treatments fail to participate, the new treatments and their potential benefits will be lost.

“We need more research into new treatments, but less than 5 percent of all adult patients with newly diagnosed cancers are enrolling in clinical trials,” Fracasso said.

Timothy Eberlein
Timothy Eberlein

Timothy J. Eberlein, M.D., the Spencer T. and Ann W. Olin Professor and director of the Siteman Cancer Center, also emphasized how essential clinical trials are to advances in diagnosis and treatment.

“At least in cancer, virtually all of the advances that we have are a result of clinical trials,” Eberlein said. “Whether it’s new surgical techniques, new drugs or new diagnostic tests — they’re all a result of clinical trials.”

Eberlein cited two primary obstacles to increased patient participation in clinical trials: the misperceptions that being in a clinical trial makes a patient a “guinea pig,” and that clinical trials are associated with much higher costs to the insurer.

Cancer research focus of Armstrong’s visit

When five-time Tour de France champion Lance Armstrong was diagnosed with testicular cancer in 1996, he felt he was given a death sentence.

“I felt hopeless,” he said. “But I quickly learned from my doctors, thanks to cancer research, new treatments were available that weren’t around just 10 years before. I’m alive today thanks to the people who participated in cancer research before me.”

On Oct. 11, Armstrong will embark on an unprecedented 3,200-mile journey across America with a team of cancer survivors, physicians, caregivers, healers, advocates and research-ers who share the mission of helping future generations move closer to the ultimate goal — a cure.

As part of the bike tour, Armstrong will make an exclusive appearance for the Siteman Cancer Center from 11 a.m.-12:30 p.m. Oct. 15 at the World’s Fair Pavilion in Forest Park.He will talk at noon about his experience with cancer and the debt he feels to the patients before him who participated in cancer research.

Shuttles will run from the Euclid Avenue depot on the Medical Campus to the World’s Fair Pavilion from 10:45 a.m.-noon. Return trips back to the Medical Campus will begin at 12:20 p.m.

Christina Carr, an ovarian cancer patient who participated in two clinical trials run by Fracasso, also understands the need for more patients to enroll in trials.

“Each trial is different. You have to approach each one with a new eye and find out what you can gain from it,” Carr said. “I’ve never had a doctor push or force me to participate.”

The other major barrier to increased clinical trial enrollment is the frequent refusal of insurance companies to pay for them. Eberlein argued that in many cases because the treatment regimens and tests are so tightly regulated in clinical trials they actually may end up being cheaper than the varying battery of tests and treatments prescribed by individual physicians.

Many minority patients hoping to participate in clinical trials have to overcome both financial issues and significant difficulties linked to trust and doctor-patient communication.

With a National Cancer Institute grant for overcoming barriers to enrollment in early stage clinical trials, Fracasso and her team will pair minority cancer patients with peer “coaches” who can be in touch with them for two years and teach them about clinical trials, cancer treatment and the risks and benefits of any therapy they elect to receive.

Also involved in that project are Mark Walker, Ph.D., instructor of medicine; Nancy Bartlett, M.D., associate professor of medicine; Katherine Jahnige, M.D., assistant professor of obstetrics and gynecology; and Edwin B. Fisher, Ph.D., Siteman Cancer Center associate director of prevention and professor of pediatrics.

“Clinical trials are extraordinarily important,” Eberlein said. “We’re seeing an explosion of basic science discoveries that are opening up a range of opportunities for earlier diagnosis, less toxic and more effective treatments and improved prevention strategies.”

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