People with certain cancers enrolled in clinical trials
survive longer, not necessarily from the treatment itself but potentially
because those enrolled are better off to begin with, according to new
research."The survival benefits for an individual to be on a cancer trial
are not necessarily to be on a trial itself.
Cancer trials select
patients who are healthier and are able to tolerate treatments," said
senior study author Dr Waddah Al-Refaie, chief of surgical oncology at MedStar
Georgetown University Hospital in Washington, DC For decades, researchers have
suspected that even if an experimental treatment isn't better than currently
available care, clinical trials could help patients because of the close
monitoring from doctors.
To determine whether clinical trials help patients
regardless of treatment success, researchers examined the survival of more than
550 000 people with cancer listed in the California Cancer Registry between
2002 and 2006.
26% decrease in the
risk of death for cancer
Researchers found a 26% decrease in the risk of death for
cancer patients enrolled in clinical trials, according to research published in
the Journal of the American College of
Surgeons. The study did not report how many people died.
The increased survival was only seen in people with lung,
colon and breast cancers. Patients with cancer of the skin, esophagus, stomach,
liver or pancreas did not have any increase in survival, researchers found. Participation
in clinical trials was extremely low, as several other studies have noted: Just
a third of one percent of patients, or 1 846 people.
Clinical trial participants tended to be younger than 65 and
affected by earlier stages of cancer, factors that could explain why enrollees
survived longer than cancer patients who didn't pursue experimental trials. Researchers
also found that participants tended to be white, a long-held issue with
When one is in a
"This is a call to broaden the criteria of clinical
trials to represent the individuals we see in the clinic: older patients,
non-whites, under-insured and sicker individuals," Al-Refaie told Reuters
Health. MORE ENGAGED, RESOURCEFUL DOCTORSHowever, the study didn't adequately
distinguish whether trials themselves can help patients, according to Colin
Begg, chair of epidemiology and biostatistics at Memorial Sloan-Kettering
Cancer Center in New York.
"That's not something that's possible to do in this
study," Begg, who was not involved in the current study, told Reuters
Health. Survival may not even be a good way to determine a clinical trial's
benefit, according to Dr Otis Brawley, chief medical officer of the American
Increased survival doesn't mean that patients live longer
with cancer, "it's that they know they have cancer for a longer period of
time," Brawley told Reuters Health. Not only do clinical trials
potentially select for healthier participants, but also for more engaged and
Doctors care most in
"Doctors who participate in clinical trials are usually
the folks who have a higher standard of care," said Brawley, who was not
involved in the study. "They learn how to maintain higher standards
through participation in clinical trials.
"Clinical trials are closely monitored by experts,
while standard treatments typically have no outside audits, which could impact
survival."Even if you're not in a clinical trial, patients who talk to
their doctors and spend a lot of time trying to understand their disease - it's
my belief that those patients end up doing better," Brawley said.