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Lack of clinical trial participation may contribute to lower survival rates


A new study finds poor survival rates among young adults and older adolescents with some cancers may be partially explained by the lack of participation in clinical trials. The study, published in the May 1, 2005 issue of CANCER (, a peer-reviewed journal of the American Cancer Society, found that age-dependent survival rates among patients with sarcomas - except Kaposi Sarcoma (KS) - correlated with clinical trial participation rates.

While survival rates among all ages overall as well as among younger and older patients have shown vast improvements over the past 25 years, the same has not been shown for patients between 15-45 years, among whom survival has improved little over the same time period. Explanations for the finding have included differences in physical tolerances to therapy, tumor biology, treatment options, health insurance coverage, and availability of new treatments and protocols.

Previous studies investigating individual cancer types, such as leukemia, have also shown that age-dependent survival may be linked to rates of participation in and availability of clinical trials. The 15-45 year age group is one of the least studied and also the least likely to be treated at a large health care institution that offers clinical trials. Participation in cancer clinical trials has been shown to improve survival. Young adults with Kaposi Sarcoma have shown significant survival and mortality benefits after improvements in clinical trial participation.

Archie Bleyer, M.D. of the M. D. Anderson Cancer Center in Houston and colleagues investigated whether KS and non-KS sarcoma survival and mortality rates were related to participation in clinical trials.

The researchers found participation in a clinical trial correlated with survival improvement in both KS and non-KS sarcomas. For soft-tissue and bone sarcomas, patients between 15 and 45 years demonstrated the least improvement. In this group, the lowest clinical trial participation rates were also noted in the group between 20-44 years. In contrast, for KS, patients between 30 and 44 years demonstrated the greatest survival increase. In this group, the greatest clinical trial participation rates were also identified in the group between 35-44 years.

The authors conclude, "based on the study reported here and others in leukemias, brain tumors, and cancer in general, lack of clinical trial participation (and of the increased knowledge of tumor biology that derives from modern clinical trials) offers one explanation" for the poor cancer survival improvements in young adults.


Article: "National Survival Trends of Young Adults with Sarcoma: Lack of Progress is Associated with Lack of Clinical Trial Participation," Archie Bleyer, Michael Montello, Troy Budd, and Scott Saxman, CANCER; Published Online: March 28, 2005 (DOI: 10.1002/cncr.20995); Print Issue Date: May 1, 2005.

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