Abstract A080: Engagement and experience with clinical trial counseling in adult glioma patients: A single institution, mixed-methods study

Abstract

Introduction:  Participation in a clinical trial offers the promise for high-quality medical care for patients with cancer, particularly glioma; however, disparities exist in the accrual of underserved patient populations, including minority patients. A multi-pronged approach for increasing the accrual of underrepresented patients to meet NIH-defined benchmarks includes optimizing patient trial education and counseling. This study seeks to assess the perceptions of the trial counseling process and barriers to trial enrollment among a diverse population of patients with low-and high-grade glioma. Methods:  Adult glioma patients who received care from the UCSF Brain Tumor Center from 2020 to 2022 participated in supervised interviews and completed a validated survey, Service Evaluation of Patient Experience of Clinical Trials and Factors Influencing Clinical Trial Entry (SPECIFIC). Thematic analysis, descriptive statistics, and Chi-square tests were used for analysis. Results:  One hundred and thirty-six patients completed the SPECIFC questionnaire. There were 44 trial participants (TPs), and 92 non-trial participants (NTPs). Compared to NTPs, TPs were on average 49.8 years old (NTPs 54.6, p=.11) and white (86.3% v. 70%, p=.009). Four core themes emerged from patient perspectives, either as facilitators or barriers to clinical trial participation: 1) Cancer Awareness/Knowledge of Scientific Research 2) Flexible Lifestyle/Affordability 3) Consistency with Values/Faith/Belief System 4) Existing Family/Community Support. Both TPs and NTPs overwhelmingly agreed that clinical trials help improve treatments for cancer. However, compared to 100% of TPs, only 57% of NTPs believed trials offered the best treatment available (p=.001). TPs were more likely to be referred to our institution specifically to enroll in a trial (p=.003), have done prior research on specific experimental treatments (p=.002), have had more than two appointments with the neurosurgeon/neuro-oncologist, and report receiving the most counseling directly from an MD level provider (p=.01).  When evaluating the trial counseling process, 93% of TPs reported willingness to consent the same day, but 5% endorsed feeling pressure to participate. TPs were satisfied with the quality of the patient information sheet, with 88% rating the information sheet as good or excellent and 88% reporting that the information sheet was easy to understand. While 14% of TPs believed the information sheet was too long, 27% and 41% desired more information about the trial therapeutic and participation requirements, respectively. Conclusion:  Overwhelmingly, trial participants were confident in the information they received and were willing to begin clinical trial enrollment on the same day of receiving information. Interventions to improve the quality and equitable delivery of patient trial education must be paired with other validated multi-dimensional strategies to reach target accrual benchmarks of underserved patient populations to therapeutic clinical trials.

Citation Format: Mulki Mehari, Sheantel Reihl, Ramin Morshed, Jasleen Kaur, Mikias Negussie, Ugomma Chukwueke, Alyx Porter, Valy Fontil, Shawn Hervey-Jumper. Engagement and experience with clinical trial counseling in adult glioma patients: A single institution, mixed-methods study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A080.