(SS#I) Integra Foundation Award (2023 Winner): Factors Affecting Willingness to Participate in Therapeutic Clinical Trials for Minority Patients with Low and High-grade Gliomas

Introduction: Participation in a clinical trial can offer a promise for high quality medical care for patients with serious illness, particularly cancer. Additionally, diversity of race, ethnicity, socioeconomics, and biological make up of study participants ensures the possibility that new therapies are accessible to the greatest number of patients. This study seeks to (1) uncover factors that influence a patient's decision to enroll in a clinical trial and (2) determine whether minority identity in low and high-grade glioma patients affects willingness to enroll.

Methods: Adult glioma patients who received care from the UCSF Brain Tumor Center from 2020 to 2022 completed a validated survey, Service evaluation of Patient Experience of Clinical trials and Factors Influencing Clinical trial Entry (SPECIFIC). Descriptive statistics, T-tests, Chi-square test and Friedman rank-order correlation tests were used for analysis.

Results: In this study, 82 trial participants (10% minority) and 192 non-trial participants (23% minority) completed the SPECIFIC questionnaire. Compared to non-trial participants, trial participants were significantly more likely to be white (83%vs74%,p=.02), non-minority (90%vs77%,p=.02), privately insured (83%vs66%,p < .001), of higher income level (79%vs65%,p=.03) and referred from the community for clinical trial consideration (29%vs5%,p < .001). Among clinical trial participants, the belief that the results could benefit future patients (45%) was the highest ranked motivating factor for enrollment. Compared to trial participants, non-trial participants were more likely to endorse a fear that “risks outweigh benefits” (22%vs0%,p < 0.001), a fear of “burden to quality of life” (14%vs0%,p < 0.001), and a concern for “costs of participation” (24%vs11%,p=0.01). Conversely, trial participants were more likely to “desire to contribute to scientific research” (95%vs82%,p=0.006), “trust physician investigators” (95%vs81%,p=0.005), and “fear a worsening of their condition without clinical trial enrollment” (22%vs12%,p=0.02) compared to non-participants.

Conclusion : Trial participants differed with respect to demographic characteristics, including minority status, and perceptions of factors influencing their decision to enroll in a clinical trial.