Cancer patients ‘have unrealistic expectations of experimental drugs’

Cancer patients taking part in early-phase clinical trials of experimental therapies may not be entering the process with realistic expectations, according to new research.

A team from the Royal Marsden NHS Foundation Trust and the Institute of Cancer Research spoke to 396 patients who were considering participation in a phase I clinical trial prior to being seen, with 301 completing an follow-up questionnaire after consultation with clinicians.

Overall, patients were shown to be keen to consider taking part in the trials, with 72 percent of those questioned planning to do so before the consultation, rising to 84 percent after speaking to a doctor.

However, it was also shown that 43 percent anticipated that the trial would result in tumour shrinkage, increasing to 47 percent after consultation. In reality, typical response rates in phase I cancer trials range from four to 20 percent, with enrolled patients surviving for a median of six months.

Study leader Dr Udai Banerji said: "The high percentage of patients expecting their tumours to shrink was a sobering finding. This creates a challenge for healthcare professionals to manage expectations, but to do so without being patronising or dismissing human hope."

Phase I trials focus on investigational treatments that have never been tested in humans. They are often restricted to patients with advanced disease who have not responded to standard therapy, with results from these studies used to determine a recommended dose ahead of phase II testing.

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