Clinical Trial Predictors

Perceived Burdens Predict Patients’ Withdrawal From Cancer Trials

https://tinyurl.com/yd2h5dnc

 

         Part and parcel of the search for improved treatment of cancer is the Clinical Trial. Recruiting suitable patients for trials and retaining them is problematic. This study looks at why recruits join trials and seeks to predict which of these will leave the trial early.

         The result showed that the likelihood of completing the trial depended on a balance between the benefits of the trial compared to the burden of participation. The benefits reported included access to medication not otherwise available, better interaction with carers, feeling good about helping others, and possible cure. The burdens of clinical trials were listed as; possible placebo treatment, lifestyle disruption, and drug side effects.

         When asked prior to trial commencement, 334 participants showed a good understanding of the benefits and burdens. Those who thought the benefits outweighed the burdens were more likely to complete the trial. Understanding this may help with recruitment and retention.

Super survivors

The genomic and immune landscape of long-term survivors of high-grade serous ovarian cancer

 

https://tinyurl.com/mvn36kwe

 

         It is somewhat of a paradox that the BRCA1/2 gene, which increases the risk of ovarian cancer also is found to be protective, in that women who carry this gene sometimes are super survivors.

         This study looked at the genome of 60 women with advanced ovarian cancer who had survived 10 years or more. Whole genome sequencing showed that these women were more likely to have genetic mutation resulting in DNA repair deficiency.

         Other genetic differences included amplification of cyclin E1 and suppression of a gene; RB1.  Normally both these genetic changes would have adverse effects, however in combination with BRCA positive status survival is sometimes enhanced. Reasons as to why this is so are yet to be determined.

Cost of cancer

Societal costs of ovarian cancer in a population-based cohort – a cost of illness analysis

 

https://tinyurl.com/5n89v4zm

 

         It is often forgotten that the impact of ovarian cancer is greater than the immediate consequences of the disease. This population-based study looked at the direct and indirect costs to society resulting from ovarian cancer, for 283 women with ovarian cancer.

         Direct costs are the price of medical care. Indirect costs are the result of loss of earnings and opportunity for the patient and their carer.

         Results from the survey showed that during the 6 year period after diagnosis the total cost per patient was about €200,000 or €30,000 each year. The cost per year decreased with longer survival. These patients pre-dated the development of precision therapy with PARPi. It is encouraging to realise that although the direct costs have increased with PARPi, because of longer survival, it may well be that the society cost is about the same or possibly decreased.