A Primer on Clinical Trials
NEWPORT BEACH, CA (thehealthchannel.com) - Clinical trials are research
studies conducted with people. Many trials try to find better ways
to prevent or treat diseases, while others test new ways to detect
or diagnose a disease. They have been responsible for virtually all
major advances in cancer treatment.
Participants take part in clinical trials for many reasons. Usually,
they hope for a cure and for a way to contribute to a research effort
that may help others. Also, participants in a clinical trial are
among the first to receive the new treatments before they are widely
available. The care they receive is always the best available.
There are three main phases of clinical trials:
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Phase I - Tests to see if a treatment is safe for humans and to determine
optimal dosages and dosing schedules (how often to give it).
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Phase II - Tests to see if the treatment works against cancer.
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Phase III - Compares the effectiveness of the new treatment against
a standard treatment.
Before a treatment is tested in a phased clinical trial, it has been
studied in a laboratory where treatments are tested on animals. But
treatments that seem to work well on animals in the lab do not always
work as well for people. That is why clinical trials are needed-to
determine the safety and effectiveness of a treatment in human patients.
To protect patients and to provide consistent testing procedures, clinical
trials must follow a strict plan called a protocol. The protocol
follows medical, ethical and legal guidelines to ensure patient safety.
It specifies the doses, frequency and duration of treatment. It also
specifies what lab work, scans or other tests are needed, as well
as their optimal frequency.
As part of the protocol, patients may be randomly assigned to one of
two study groups-one group that receives the treatment being researched
and one that receives the standard treatment.
Research protocols for clinical trials have to go through an extensive,
independent, peer review process by a separate board of scientists,
doctors, nurses, and laypersons not connected with the trial before
they are approved. These boards are called Institutional Review Boards
or IRBs. In addition, these boards review the progress of the trials
on a yearly basis. These reviews provide additional assurance to
women entering breast cancer research trials that the trials are
properly designed and monitored.
Participation in clinical trials is tightly controlled and patients must
meet specific criteria before they can participate. Also, it is important
to note that any standard treatments you receive could affect your
eventual eligibility in a particular trial. Therefore, you may want
to discuss clinical trial options with your oncologist prior to initiating
treatment.
Studies may have one, two, three, or even four different treatment plans.
Participants in studies with more than one treatment plan are randomized
(chosen by a flip of a coin) to receive one of the plans. One plan
may be the standard treatment, while the other plan(s) may have different
therapies, treatment schedules, or higher doses. All participants
are monitored closely.
If your treatment does not seem to be helping, the medical doctor can
decide to take you off the trial. Also, you can personally decide
to leave the trial at any time. If you leave the trial for any reason,
your continued care will not be jeopardized.
Lack of Awareness
Unfortunately, the vast majority of cancer patients do not take part
in clinical trials. In a presentation to delegates at the recent
annual meeting of the American Society for Clinical Oncology, Dr.
Robert Comis of the MCP Hahnemann University Clinical Trials Research
Center in Philadelphia said that 84 percent of cancer patients are
simply unaware of clinical trials or not sure that they would be
an option for them. The findings were based on a survey of 6,000
cancer patients by Harris Interactive.
Only 4 percent of the cancer patients interviewed by Harris Interactive
said they had participated in clinical trials, and the majority of
them heard about the possibility through their physician. About 58
percent of the respondents said they would never participate in a
clinical trial; fear of getting insurance coverage for the trial
costs was mentioned as a concern by a majority of these respondents.
They also cited worries that they would not get the best treatment
or that they would get a placebo instead of a real drug. More than
20 percent said they would feel like a “guinea pig.”
Yet, in the same survey 97 percent of the patients who had participated
in clinical trials said they received excellent or good quality care
and that they were treated with dignity. And the vast majority said
they would recommend participating in clinical trials to others.
Eighty-six percent of the patients also said they were able to secure
insurance coverage for their participation.
Is a Clinical Trial For You?
Before you decide to take part in a clinical trial, you should know as
much as possible. Ask your medical doctor for more details on the
trial, such as:
What is the purpose of the study?
How many people will be included in the trial?
What does the study involve? What kinds of tests and treatments will
I have?
How are treatments given and what side effects should I expect?
What are the risks and benefits of each protocol?
How long will the study last? What type of long-term follow-up care is
provided?
Will I have any costs? Will any of the treatments be free? What does
my insurance cover? Is financial aid available?
If you want additional information regarding ovarian cancer clinical
trials, ask your doctor what trials may be open to you. And the following
organizations may also be helpful:
CancerNet - National Cancer Institute
900 Rockville Pike
Building #31, HSV2580, Room 10A046
Bethesda, MD 20892
1-800-422-6237
CenterWatch Clinical Trials Listing Service
581 Boylston Street, Suite 200
Boston, MA 02116
617-247-2327
SOURCE:
The National Cancer Institute Web Site
Written by Richard A. Zmuda, thehealthchannel.com Editorial Team