Many cancers have become manageable chronic diseases, thanks in part to the blaze of innovation by biopharmaceutical companies since the “war on cancer” began more than 40 years ago. In 2012, the five-year survival rate for patients with any cancer hit an all-time high of 68 percent. While life expectancies for patients diagnosed with skin, breast and prostate cancers have improved significantly, pancreatic cancer remains among the most deadly; the five-year survival rate for patients with this disease is just 6 percent. In fact, according to the American Cancer Society’s Cancer Facts & Figures 2013 report, pancreatic cancer death rates have slowly increased during the past decade.
Although pancreatic cancer is one of the deadliest cancers in the United States, few patients and doctors discuss clinical trial enrollment, which could improve patient outcomes. The Pancreatic Cancer Survey: Learning Through Experiences, which was announced last month by the Pancreatic Cancer Action Network and Celgene, found that only 19 percent of people diagnosed with pancreatic cancer discussed clinical trial participation with their doctors prior to receiving their first treatment.
Patient participation in clinical trials is a key driver of innovative therapies for all cancers and is particularly vital in the area of pancreatic cancer treatment.
“It is critical to help patients and their caregivers learn about treatment options, including clinical trials, as early as possible, particularly given the aggressive nature of pancreatic cancer,” Julie Fleshman, president and CEO of the Pancreatic Cancer Action Network, said. Fleshman encourages patients to consult their Patient and Liaison Services (PALS) program, which helps guide patients to appropriate pancreatic cancer trials. PALS has a comprehensive database that is aligned with ClinicalTrials.gov.
The Pancreatic Cancer Action Network analyzed clinical trial enrollment data in a separate study to understand barriers to trial enrollment for pancreatic cancer patients. The findings, which were published in the August edition of the Journal of Clinical Oncology (JCO), indicate that pancreatic trials that opened in 2011 are expected to take 6.7 years to complete enrollment, much too long to make rapid progress against a cancer that kills approximately 74 percent of those diagnosed within a year.Currently, less than 5 percent of pancreatic cancer patients participate in trials. Bumping up that number to shorten enrollment periods would be a huge step forward.
The JCO study also highlighted that physician recommendations often influenced enrollment decisions. Yet patients and their doctors do not discuss clinical trial enrollment often, according to the recent patient survey. Better communication about which patients are eligible and more clinical trial locations that are close to patients could both help accelerate enrollment.
“Having the right number and balance of carefully designed clinical trials will facilitate accrual of patients in a timely manner, allow patients access to increased options to receive the best care, and answer questions necessary to move the field forward and ultimately improve patient outcomes,” said Lynn Matrisian, PhD, vice president of scientific and medical affairs of the Pancreatic Cancer Action Network and lead author on the study.
Since the start of the new millennium, the number of cancer therapies has increased by 52 percent, with survivorship up 47 percent. None of this dramatic progress would have been possible without the willingness of patients to participate in clinical trials. But for pancreatic cancer, increasing enrollment in clinical trials is critical if we are to have any chance of beating the odds.