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abstract
Background. We conducted this retrospective study to identify reasons that patients referred to a phase I clinical trial failed to enroll or delayed enrollment onto the trial.
Materials and Methods. Outcome
analyses were conducted independently on data collected from electronic
medical records of two sets of consecutive
patients referred to a phase I clinical trial
facility at MD Anderson Cancer Center. Data from the first set of 300
patients
were used to determine relevant variables affecting
enrollment; data from the second set of 957 patients were then analyzed
for these variables.
Results. Results
from the two sets of patients were similar. Approximately 55% of
patients were enrolled in a phase I trial. Patients
referred from within MD Anderson were more likely
to be enrolled than patients seen originally outside the institution (p = .006); black patients were more likely than white patients to enroll (69% vs. 43%; p
= .04). The median interval from the initial visit to initiation of
treatments was 19 days. Major reasons for failure to
enroll included failure to return to the clinic
(36%), opting for treatment in another clinic (17%), hospice referral
(11%),
early death (10%), and lack of financial clearance
(5%). Treatment was delayed for three weeks or more in 250 patients; in
85 patients (34%), the delay was caused by
financial and insurance issues.
Conclusion. Failure to return to the clinic, pursuit of other therapy, and rapid deterioration were the major reasons for failure to enroll;
lengthy financial clearance was the most common reason for delayed enrollment onto a phase I trial.
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