Clinical Trial Participation Among Patients With Pancreatic Cancer: A Pancreatic Cancer Action Network Patient Survey

PURPOSE Despite ongoing efforts, outcomes among patients with pancreatic ductal adenocarcinoma (PDAC) remain poor. Clinical trials are indispensable for therapeutic innovation, yet accrual among patients with PDAC remains suboptimal. This study aimed to identify factors associated with clinical trial offer and participation using data from a large patient survey. METHODS In collaboration with the Pancreatic Cancer Action Network (PanCAN), we conducted a Health Insurance Portability and Accountability Act–compliant electronic survey of patients and caregivers. The survey collected self-reported data on demographics, clinical characteristics, and health care access. Logistic regression was used to assess associations with clinical trial offer and participation. Multivariate models included variables significant on univariate analysis ( P < .05). RESULTS Of 1,046 sampled patients with PDAC, 284 (27.2%) were offered and 204 (19.5%) participated in clinical trials. Patients with stage IV disease had the highest odds of being offered (odds ratio [OR], 2.36 [95% CI, 1.56 to 3.53]) and participating (OR, 2.21 [95% CI, 1.40 to 3.49]) compared with those with stage I disease. Stage II/III patients were more likely to be offered trials (OR, 1.50 [95% CI, 1.04 to 2.18]), but less likely to participate (OR, 0.65 [95% CI, 0.45 to 0.94]) than those with stage IV. Treatment at academic hospitals was associated with greater odds of both trial offer (OR, 1.82 [95% CI, 1.37 to 2.44]) and participation (OR, 2.44 [95% CI, 1.72 to 3.33]) compared with community practices. Increasing age was associated with a trend toward decreased likelihood of being offered a trial (OR, 0.98 per year [95% CI, 0.97 to 1.00], P = .03). CONCLUSION Significant disparities in clinical trial access and participation persist among patients with PDAC. Targeted strategies are needed to improve trial engagement across age groups, disease stages, and treatment settings.