Decision-making from multidisciplinary team meetings to the bedside: factors influencing the recruitment of breast cancer patients into clinical trials.

ABSTRACT

AIM OF THE STUDY Our aim was to determine factors influencing physicians and breast cancer patients to respectively propose or accept participation in a clinical trial following proposals made during a multidisciplinary team meeting (MTM) in a Comprehensive Cancer Centre. PATIENTS AND METHODS: Consecutive patients considered eligible for a clinical trial by a breast cancer-specific MTM were included. A detailed analysis of factors predictive of the physician proposing the trial and the patient's acceptance and final inclusion was conducted. RESULTS: MTM proposed 547 inclusions in 25 clinical trials for 397 patients between March and September 2011. The physician proposed the scheduled clinical trial in only 39% of the cases. The patients accepted the proposal in 74% of the cases, and finally 29% were included. The main reason for non-inclusion was the physician's failure to propose the trial in 45-81%, depending on the type of study. The only factor predictive of both the physician proposing the trial and final inclusion was the type of study (both p < 0.001). Diagnostic/prognostic studies were the most frequently proposed trials. The professional status (of the subject) was predictive of acceptance (p = 0.03) with higher rates among retired patients and executives (84 and 76% respectively). CONCLUSION: The major reason for non-inclusion in clinical trials was the physician's failure to propose the trial, while the patient's professional status and the type of study influenced both physicians and patients. Educative measures mostly directed at physicians could be implemented to overcome such poor compliance.