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Take Away Points:
- Patients do better when in clinical trials, perhaps because they get more expert care and closer supervision.
- Accrual rates are dismally low for clinical trials studying adult cancers.
- Good therapeutic options for CLL now exist outside of clinical trials which makes enrollment even more difficult.
- We still need clinical trials to get to a cure for CLL.
Dr. Bill Wierda discusses clinical trials from a patient’s and a researcher’s perspective.
Despite the fact we do better within clinical trials than out, accrual rates are very low. Only about 5% of eligible adult patients in the USA enroll in cancer clinical trials.
Dr. Wierda mentions some of the issues that slow enrollment in our interview.
To his list I would add:
- Expense: many of the costs, including travel are not covered by insurance.
- CT Scans: the requirement of multiple CT scans scares off patients. See our lengthy discussion and research on the associated risks here and here.
- Lack of cross-over in some Phase 3 trials: this is getting much better but it is still not 100%. It has lead to terrible consequences where patients had to die in one therapy arm to prove the superiority of a different arm. This important statement on clinical equipoise by Dr. O’Brien should be mandatory reading for all patients and researchers. My interview with Dr. Susan O’Brien lets her bluntly express her strong opinion on trial design.
I am alive because of a clinical trial and so are thousands of others. Clinical trials are the only way we will cure CLL.
Please enjoy our discussion.
Brian Koffman, MD