Enrollment in a Clinical Trial?
My husband was recently diagnosed with lung cancer and is considering other treatment options or even enrolling in a randomized trial. I would be worried that if he does enroll in a trial, he would receive a placebo and not be treated properly. I am desperately seeking help – I want him to get the best treatment in the country.
Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine, responds:
Many patients choose not to enroll in clinical trials for the very concerns that you raise. Enrollment in a randomized trial means that you could either receive one treatment or another, which may sometimes be a placebo drug, and that you have no control over which treatment you receive. Instead, the choice is left up to chance. Not all patients are comfortable with the concept of being randomized, and this is a very personal decision. However, many randomized trials for non-small cell lung cancer, particularly those that are assessing chemotherapy and other systemic therapy drugs, randomize patients to receive the currently accepted standard of care drug(s) with or without the addition of another drug that is not a widely accepted standard drug to treat non-small cell lung cancer but that has demonstrated some evidence of activity in fighting this cancer. In such cases, even in the placebo arm, patients would be receiving the currently best accepted treated regimen for their cancer. In the experimental or interventional arm, the additional drug can offer a chance of increased tumor killing, but it also can increase the risk of side effects from therapy. Such trials are attempting to identify the best way to treat future patients with non-small cell lung cancer, and many patients are motivated by the chance of improving their own disease course while also feeling a sense of altruism towards other patients. If he takes part in the clinical trial, your husband will be contributing to the advancement of knowledge of how best to treat non-small cell lung cancer, and I hope that any knowledge learned will help to lead to improved survival for futures patients with lung cancer.