A new analysis of a clinical trial for glioblastoma, a fast-growing brain cancer, reveals why many patients did not fully participate. Researchers looked at data from the EPCOG trial, which tested early palliative care for people with this aggressive disease.
Of 556 patients screened, only about 41% enrolled. The most common reasons for not joining were lack of interest (25.7%) and low functional status (11.5%). Among those who did enroll, many dropped out, mainly due to death (57.6%) or illness (5.2%).
Even among patients who stayed in the trial, visits were often skipped or delayed. For example, neurosurgical visits were skipped 43.3% of the time and delayed 56.4% of the time. Specialized palliative care visits were skipped less often (4.5%) but still delayed 11% of the time.
The study highlights the challenges of conducting research in very sick patients. The authors note that the high vulnerability of glioblastoma patients must be considered when designing future trials. This analysis does not report on the effectiveness of palliative care, only on participation patterns.