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04-08-2021 | COVID-19 | News

Cancer clinical trial recruitment bounces back after initial COVID-19 wave

Author: Shreeya Nanda


medwireNews: Recruitment to oncology clinical trials fell markedly during the first wave of the COVID-19 pandemic, but the subsequent wave saw “only a modest” decrease, say US researchers.

“These findings suggest that clinical trial research rapidly adapted to the circumstances of enrolling and treating patients on protocols during the COVID-19 pandemic,” they write in JAMA Network Open.

A total of 29,398 patients were enrolled in clinical trials conducted by the SWOG Cancer Research Network in January 2016–February 2021, with 24,034 enrolled before the pandemic and 5364 during the pandemic (March 1, 2020–February 28, 2021).

Using interrupted time-series analysis, the team found a significant 9% model-estimated decrease in enrollments per week during the initial wave (March 1–April 25, 2020) relative to the prepandemic period. This reflected a decrease in the total number of patients enrolled from an expected 1087 had the pandemic not occurred to 730 in actuality.

The recruitment rate subsequently recovered between April 26 and October 3, 2020, with a significant model-estimated weekly increase of 4% relative to before the pandemic, but the absolute number of enrollments remained lower than expected, at 2295 versus 3079.

There was another significant drop in enrollment during the winter wave of the pandemic (October 4, 2020–January 23, 2021), but by only 2% per week relative to the prepandemic period after adjustment for seasonal variations in trial enrollments.

In all, the model-estimated number of expected enrollments during the 1-year pandemic period was 6913, compared with 5344 actual enrollments, equating to a significant 22.7% decrease.

This reduction appeared to primarily be driven by decreases in recruitment to cancer control and prevention trials, with expected and observed enrollments during the pandemic of 2641 and 1421, respectively, which equated to a significant fall of 46%.

By contrast, enrollment to treatment trials fell by a nonsignificant 9%; the expected and actual number of recruited patients was 4304 and 3922, respectively.

Joseph Unger (Fred Hutchinson Cancer Research Center, Seattle, Washington) and colleagues speculate that “this pattern could reflect institutional prioritization of resources to target the conduct of trials most directly related to patient care.”

They continue: “Future studies should be conducted to evaluate the quality of data collection and the potential influence on clinical outcomes in patients with cancer enrolled in trials during the pandemic.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group

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JAMA Netw Open 2021; 4: e2118433