Most children with cancer are not enrolled on a clinical trial in Canada: a population-based study

• Published in: BMC cancer 2017-06, Vol.17 (1), p.402-402, Article 402
• Main Authors: Pole, Jason D, Barber, Randy, Bergeron, Rose-Émilie, Carret, Anne Sophie, Dix, David, Kulkarni, Ketan, Martineau, Emilie, Randall, Alicia, Stammers, David, Strahlendorf, Caron, Strother, Douglas R, Truong, Tony H, Sung, Lillian
• Format: Article
• Language: English
• Subjects: Acute lymphoblastic leukemia; Adolescent; Age; Analysis; Astrocytoma; Astrocytoma - drug therapy; Canada; Cancer; Care and treatment; Child; Child health; Child, Preschool; Children; Children & youth; Clinical trial enrollment; Clinical trials; Clinical Trials as Topic - methods; Cytochrome P-450; Diagnosis; Enrollments; Epidemiology; Female; Health risk assessment; Humans; Infant; Infant, Newborn; Leukemia; Lymphatic leukemia; Male; Medical diagnosis; Medical Oncology - methods; Neoplasms - drug therapy; Oncology; Patient Selection; Patients; Pediatrics; Population studies; Population-based; Population-based studies; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Retrospective Studies; Socioeconomic factors; Studies; Teenagers; Young adults
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3390-6

Primary objective was to describe the proportion of children newly diagnosed with cancer enrolled on a therapeutic clinical trial. Secondary objectives were to describe reasons for non-enrollment and factors associated with enrollment on trials. In this retrospective cohort study, we included children newly diagnosed with cancer between 0 and 14 years of age and diagnosed from 2001 to 2012. We used data from the Cancer in Young People in Canada (CYP-C) national pediatric cancer population-based database. CYP-C captures all cases of pediatric cancer (0-14 years) diagnosed and treated at one of the 17 tertiary pediatric oncology centers in Canada. Non-enrollment was evaluated using univariate and multiple logistic regression analysis. There were 9204 children with cancer included, of whom 2533 (27.5%) were enrolled on a clinical trial. The most common reasons cited for non-enrollment were lack of an available trial (52.2%) and physician choice (11.2%). In multiple regression, Asian and Arab/west Asian race were associated with lower enrollment (P = 0.006 and P = 0.032 respectively). All cancer diagnoses were more likely to be enrolled compared to astrocytoma and children with acute lymphoblastic leukemia had an almost 18-fold increased odds of enrollment compared to astrocytoma (P