Six months into her role heading the University of Pittsburgh Cancer Institute, Dr. Nancy E. Davidson says one of her goals is to increase participation in clinical trials, a key element in improving cancer treatment options.
"Virtually every treatment we have is the result of clinical trials done in the past," Davidson said this week. "It's what's driving a lot of what we accomplish."
Davidson, an expert in breast cancer research, took over as director of the institute March 1. She came from Johns Hopkins University School of Medicine in Baltimore.
Increasing clinical trial participation is one of several priority projects at the institute, which provides services in western Pennsylvania, West Virginia and Ohio.
The institute is preparing for an assessment for renewal of its designation by the National Cancer Institute as a Comprehensive Cancer Center, one of only 40 nationwide. Also on Davidson's agenda are applications for several major grants, including $200 million in so-called Challenge grants.
Davidson said more needs to be done to educate the general public of the critical need for clinical trial participation. Nationally, experts say a very small percentage of cancer patients participate.
A 2008 editorial in The Oncologist cited data showing that only half of the clinical trials sponsored by the National Cancer Institute enrolled enough participants to achieve meaningful results.
A review of dozens of ongoing trials at University of Pittsburgh Cancer Institute shows that while some have accrued their desired enrollment goals, others have signed up only small percentages.
According to a spokeswoman, about 30 percent of the institute's patients are enrolled in clinical trials.
Davidson said there are several reasons why cancer patients, already frightened by a feared diagnosis, are reluctant to sign up.
"They may be thinking, 'I'm going to be some kind of a guinea pig,' " she said, adding that patients might fear that they would get a placebo rather than actual treatment.
"I can understand where that fear comes from, but it's not valid."
Davidson said cancer trials are tightly regulated. Increased monitoring that accompanies clinical trial participation means "standard of care plus," she said.
Another issue hindering participation is the denial of insurance coverage for some patients, especially the elderly, who are at increased risk for cancer, Davidson said.
A particular concern is with the Medicare Advantage program. Davidson said she and her colleagues have been seeking Congressional support for a change in that program to include payments for clinical trials.
"This is a huge challenge," she said, adding that the restricted coverage "slows down progress."
Davidson said in addition to increased education efforts, physicians, nurses and others involved in the care of cancer patients need to make a greater effort to inform patients of trials and potential benefits.
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