Evaluating the impact of financial toxicity among cancer clinical trial participants

This is the authors' abstract. We don't add key points for this paper.

#Introduction Cancer precision medicine as part of standard of care (SOC) or clinical trials (CT) requires access to high cost advanced diagnostics and therapeutics. The difference in out-of-pocket (OOP) costs associated with cancer treatment as part of SOC versus CTs remains limited. This study sought to evaluate the varying financial burden and toxicity among cancer patients receiving treatment at an academic medical center as part of a CT versus SOC. #Methods Patients presenting to medical oncology clinic at an academic medical center for a new or follow-up visit, who were English-speaking and able to provide informed consent, were approached for a one-time survey from July 2018 to August 2020. Study participants provided demographic, clinical, financial, and patient reported outcomes data. #Results A total of 67 participants completed the survey. In the study, CT participants were significantly younger than SOC participants (CT, mean 57 years, SD=13.5; SOC, mean 67, SD=10.7; p=0.002). The mean time since diagnosis was significantly longer among SOC participants at 7.9 years (SD=7.3) compared to CT participants at 2.7 years (SD=3.9) (p=.001). Most participants were non-Hispanic white (SOC, 78%; CT 71%). A significantly higher proportion of CT participants reported OOP cost exceeding $1,000 in the prior 30 days compared to SOC participants (SOC, 8.3%; CT, 16.1%, p<0.001). Significantly more SOC participants felt very comfortable discussing cost with their cancer doctor compared to CT participants (SOC, 69%; CT, 35%; p=0.02). #Conclusions This study observed significantly higher OOP cost and financial toxicity among participants receiving treatment within a CT compared to SOC. Future research will need to fully evaluate the financial burdens associated with CT participation.