Cancer can affect people from all walks of life, so it’s important that clinical trials study new treatments across every group who may need them.
That’s why Dr. Monica Patel, a gastrointestinal medical oncologist at UW Health | Carbone Cancer Center and assistant professor of hematology, medical oncology and palliative care at the University of Wisconsin School of Medicine and Public Health, is investigating ways to increase clinical trial participation across different age groups, genders, racial and ethnic backgrounds, and those who live in rural areas versus cities.
“Particularly for patients with cancer, clinical trials are incredibly important,” Patel said. “Clinical trials give patients access to cutting-edge therapies, so everyone should have that access, and on the other side, these trials test safety and effectiveness of treatments, so we don’t know how well they will work for some patients until we’ve tested them in all populations.”
Patel, who is also Faculty Director of Health Equity in Clinical Research at Carbone Cancer Center, is leading a clinical trial to train more oncologists in TrialTALK, a medical decision-making conversation tool developed at UW, in the hopes of improving awareness and access to trials for underserved patients.
A key barrier to clinical trial participation is whether oncologists are talking to their patients about clinical trials in general, as well as potential studies patients could join. A review of 20 years of cancer clinical trial data showed that more than half of cancer patients who were informed of clinical trial opportunities chose to participate.
TrialTALK was developed by UW researchers using evidence-based strategies to create a conversational framework to explain a patient’s diagnosis and map all possible treatment options, including clinical trials, based on the patient’s goals. This method includes both face-to-face conversations as well as making pen-and-paper diagrams that patients can take with them. These conversations happen continually to ensure the patient can ask questions and make informed decisions.
“Every conversation is different, you definitely have to adjust for your patients, but it gives you a general framework and allows a more natural discussion,” Patel said. “And you’re talking about everything earlier in their care and not rushing through some topics like clinical trials, where patients may not feel like it’s a real option.”
Patel hopes the structure of TrialTALK’s method can provide more equitable discussion of clinical trial opportunities with underserved patients. The trial she’s leading is focused on increasing Black patient representation. Data shows these patients make up a disproportionately small percentage of clinical trial participants.
“It reminds you to talk about clinical trials with every patient, regardless of who they are, so if it becomes your standard practice we can remove or consciously address unconscious bias,” she said.
This new trial includes training oncologists in TrialTALK through an online course. Researchers also will seek feedback from patients whose oncologists implement TrialTALK strategies. Northwestern Medicine in Chicago and Medical University of South Carolina are also participating sites for this study.
Patel advises all cancer patients to ask their oncologists about potential clinical trial options for their own care. Carbone’s clinical trials website includes patient resources and information on how to get involved in ongoing trials.