Clinical trials are vitally important in the fight against cancer and, as with most medical research, women are often underrepresented. In part one of our two-part series highlighting women’s participation in clinical trials for National Cancer Research Month and Women’s Health Week, we spoke with Anna Priebe, M.D., FACOG, a gynecologic oncologist at Texas Oncology–Tyler and Longview Cancer Center, about the value of participating in leading-edge cancer research, underscoring the importance of trust between patient and physician.
Historically, women have been underrepresented in clinical trials/medical research. Is this the case with cancer research?
Yes, it’s the case for many areas of medicine. Ultimately, you want the population of the clinical trial to be a smaller version of the population that will be receiving the treatment in the real world. For decades, research subjects were a homogenous group of participants. Trial results were assumed to be applicable to everyone, but the trial participants were not representative of the broader population of patients who end up getting treated off trial. This led to incorrect conclusions that most people behave and react to medications the same way. Over time, we’ve learned that there is variation in how a person responds to medication and how effective that medication may be for them due to sex, ethnicity, and even on an individual level. These realizations have led to the concepts of pharmacogenetics and pharmacogenomics and the development of precision medicine or “personalized medicine,” which allows physicians to select treatments that are most likely to help patients based on a genetic understanding of their disease.
Texas Oncology–Tyler is a hub for cancer research and innovation. Why is it important to perform cancer research outside of the major metro areas and how has cancer research changed for women in Tyler over the past few years?
Access to clinical trials for patients in the community and rural setting is something that we are passionate about at Texas Oncology and it’s important for both the patient and the research community."
Patients that can travel for clinical trials are a very select group of patients. If we draw conclusions based on a narrow group of people, ultimately those results may be skewed and not representative of the larger population.
With trial access, patients can benefit from earlier access to new treatments and just as importantly, they can be represented on a genomic level, giving us a better understanding of groups that otherwise may not be represented in cancer research.
Over the past two years, we’ve specifically focused on expanding the portfolio of clinical trials for gynecologic cancers, allowing women in the area to access new, leading-edge treatments.
How important is the patient/physician relationship when enrolling patients who are participating in clinical trials?
Like every relationship, trust and communication are the foundations for a successful physician/patient relationship."
Medicine is complex and there are many factors that are considered when it comes to the treatment of an individual patient. It cannot be replaced with a Google search. Trust plays a huge part in the physician patient relationship regardless of whether clinical trials are involved. We are all, at some point in our lives, reliant on the advice of others who are experts in their field and ultimately, we determine whether we feel comfortable with that person and trust that they are honest and have our best interest at heart. As medical professionals, we must be able to convey complicated topics in a way the patient can understand and outline the risks and benefits of a particular course of action. While clinical trials have added complexity and generally require a greater time commitment in terms of testing and appointments from the patient and physician, patients are very closely monitored and have the potential of receiving a new, more effective treatment that will become a standard of care.
For part two of our series, posted on Friday, May 14, we’ll meet two of Dr. Priebe’s patients who participated in clinical trials for ovarian cancer. They’ll discuss their experience and share their advice for other patients who may be considering a clinical trial.