Abstract
Background
Our research group recently surveyed the clinical trial landscape in pancreatic adenocarcinoma
and identified 430 active trials. These represent an opportunity to expand treatment
options for patients with pancreatic adenocarcinoma. Our primary objective was to
detail clinical trial participation among patients with pancreatic adenocarcinoma.
Our secondary objective was to evaluate survival.
Methods
We queried the National Cancer Database (2004–2016) for patients with pancreatic adenocarcinoma.
Patients were stratified by trial participation: clinical trial or non-trial. Multivariable
logistic regression was used to identify variables associated with trial participation.
The Kaplan-Meier method and multivariable Cox hazards regression were used to analyze
survival.
Results
In total, 261,483 patients were included: 1,110 (0.4%) were enrolled in a clinical
trial. A total of 57 Black patients participated in a clinical trial (0.19% of Black
patients). This was lower compared to White patients (n = 955, 0.49% of White patients, P < .001). After adjusting for demographic and clinical factors, Black patients were
less likely to be enrolled in a clinical trial (odds ratio = 0.387, P < .001). Patients treated at nonacademic medical centers were less likely to be in
a clinical trial.
Trial participation was associated with an increased median survival relative to non-trial
patients (stage IV: 9.0 vs 3.8 months, P < .001), and this association remained on multivariable regression (hazard ratio =
0.779, P < .001).
Conclusion
Fewer than 1% of patients with pancreatic adenocarcinoma participated in a clinical
trial. There are racial and sociodemographic disparities in clinical trial enrollment.
An association was observed between clinical trial participants and prolonged survival.
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Article info
Publication history
Published online: November 26, 2021
Accepted:
October 8,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
