The PACCT study is a health equity-focused multi-level intervention to improve the quality of patient-provider discussions of cancer clinical trials and the subsequent accrual of Black and White patients with prostate cancer into clinical trials. The effectiveness of the patient-facing intervention was recently tested in a randomized controlled trial in several outpatient oncology clinics within the Karmanos Cancer Institute in Detroit, Michigan and the Sidney Kimmel Cancer Center in Baltimore, Maryland. The five-year trial was funded by the National Cancer Institute.
Only 44 (22.1%) of participating patients (n = 199) became potentially eligible for an available clinical trial. Patients with higher incomes were more often eligible (>$80,000 vs. <$40,000, adjusted OR = 6.06 [SD, 1.97]; $40,000–$
79,000 vs. <$40,000, adjusted OR = 4.40 [SD, 1.81]). Among eligible patients randomized to the intervention (n = 19) or usual care (n = 25), Black patients randomized to the intervention reported participating more actively than usual care patients, while White intervention patients reported participating less actively (difference, 0.41 vs. −0.34). Intervention patients received more trial invitations than usual care patients (73.7% vs. 60.0%); this effect was greater for Black (80.0% vs. 30.0%) than White patients (80.0% vs. 66.7%). Findings suggest the greatest enrollment barrier is eligibility for an available trial, but a communication intervention can improve communication quality and trial invitation rates, especially for eligible Black patients.
Findings from the primary study can be found here.
Citations to other PACCT manuscripts can be found below.