Dr Theresa Keegan on Barriers, Facilitators to Clinical Trial Participation Among AYAs

Theresa Keegan, PhD, MS, associate professor, hematology and oncology, University of California at Davis Comprehensive Cancer Center, outlines barriers and facilitators to clinical trial participation among adolescents and young adults (AYAs).


What are some barriers and facilitators to clinical trial participation among adolescents and young adults (AYAs)?

There’s a number of barriers, and we really focus on barriers in our session, mostly because of the low overall trial enrollment rate. Some facilitators is that there’s a hope for clinical benefit or just general altruism. But, I think in terms of barriers, it’s much more complex, and it really starts kind of at the structural level. Are there clinical trials available nationally, and are they available at a particular institution? Those are sort of the initial barriers. And then, is a patient eligible for that particular trial? Are there age restrictions that warrant this patient or specific characteristics of their cancer that make them ineligible?

The next sort of level of barriers are provider-level barriers. These are really the providers knowing about available clinical trials, communicating research with AYAs, and their ability to do so in order for them to understand what they’re getting into with a clinical trial.

And then I would say the patient-level barriers. Those are also pretty substantial for AYAs, and those include things like concerns about the side effects that may occur with clinical trials, concerns about prolonged hospitalizations, general concerns about experimentation, actually, and lack of peer support. I would say unique to AYAs is that they’re very concerned with the extra time that the treatment would involve if they were to participate on a clinical trial.  
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