Clinical Trials
What Are Clinical Trials?
Clinical trials are research studies that involve people. Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease.
Researchers design cancer clinical trials to test new ways to:
- Treat cancer
- Find and diagnose cancer
- Prevent cancer
- Manage symptoms of cancer and side effects from its treatment
Read the full article on the National Cancer Institute website.
Is patient participation in cancer drug trials associated with longer survival?
Many cancer clinical investigators view clinical trials as offering better care for patients than routine clinical care. However, definitive evidence of clinical benefit from trial participation has yet to emerge, said the authors of this 2024 study Survival Benefit for Cancer Trial Participants Does Not Persist in Adjusted Analyses (published in JAMA, 2024 May 20).
They conducted a systematic review and meta-analysis of the evidence examining whether patient participation in cancer trials was associated with greater survival benefit compared with routine care (emphasis added).
Thirty-nine publications were included, comprising 85 comparisons of trial participants and routine care patients. The meta-analysis revealed a statistically significant overall survival benefit for trial participants when all studies were pooled, regardless of design or quality.
However, survival benefits diminished in study subsets that matched trial participants and routine care patients for eligibility criteria and disappeared when only high-quality studies were pooled. They also disappeared when estimates were adjusted for potential publication bias.
Previous systematic reviews, including those focused on cancer, have not detected clear evidence that patients in randomized trials have better outcomes than patients outside them.1,5,9,12,13 Despite this, many factors may contribute to the perception that patients have better outcomes in trials. One is that participants in trials often experience better care processes, including more frequent imaging. Another is the notorious efficacy-effectiveness gap.
The authors concluded: Many studies suggest a survival benefit for cancer trial participants. However, these benefits were not detected in studies using designs addressing important sources of bias and confounding. Pooled results of high-quality studies are not consistent with a beneficial effect of trial participation on its own.
Authors: Renata Iskander 1, Hannah Moyer 2, Karine Vigneault 1, Salaheddin M Mahmud 3, Jonathan Kimmelman 1
Affiliations
1Department of Equity, Ethics and Policy, McGill University, Montreal, Quebec, Canada.
2Department of Medicine, Temple University, Philadelphia, Pennsylvania.
3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Where can I get more information?
Ask your Doctor/Oncologist about Clinical Trials that may be of interest to you, or visit these websites. Note: Many Clinical Trials are open to people from outside the country in which the trial is taking place.
Europe
European Organisation for Research and Treatment of Cancer
Ireland
Cancer Trials
United Kingdom
Medical Research Council
International
Center Watch
U.S.A
ClinicalTrials.gov
National Cancer Institute
Updated 2024