The aim of clinical trials is to find new cancer treatments or to see whether a new treatment is better than an existing treatment. Every year hundreds of clinical trials open around the world for patients with breast cancer, although not all are available in Australia.
Currently only around six per cent of Australians diagnosed with cancer participate in a clinical trial. It is likely that the number of Australians with metastatic breast cancer participating in clinical trials is even less. However, there is no data to give accurate statistics.
If you are living with metastatic breast cancer, participating in a trial can sometimes be a way to get a new treatment that may otherwise not be available to you. You may worry about not getting the new treatment if you are randomised to the standard treatment arm. It is important to remember that this is the treatment that you would have received if you were not on the trial. In some instances, you may also be able to cross over to the new treatment if the trial is showing that this treatment has significant benefits over the standard treatment.
People often tell us that it is difficult to find a trial that is suitable for them. Many trials in metastatic breast cancer place restrictions around what previous treatments participants can have received, so you may find your past treatments make you ineligible. Young women can find it very difficult to find a trial, as many only recruit women who are post-menopausal. Men with breast cancer report many challenges finding trials for which they are eligible. People with culturally and linguistically diverse backgrounds, on lower incomes or living in rural and regional areas are often underrepresented in clinical trials.
Adding to the complexity of finding a clinical trial that may be right for you is the fact that there are fewer and fewer large international trials that recruit broadly across breast cancer. Part of the reason for this is the emerging awareness that breast cancer is not just one disease but a complex collection of many different subtypes of cancer. Many trials are now very specific to a particular subtype of breast cancer (e.g. HER2-positive, hormone positive or triple negative), ruling out people who do not have that subtype. This can also mean it can take longer to recruit enough people to a trial to find statistical differences between a standard treatment and a new treatment. It is these statistical differences that show whether the new treatment is better that the current treatment.
Increasing the number of people participating in clinical trials is important to ensure that effective new drugs that can both extend length of life and the time that a cancer can be kept at bay become available. If you are interested in participating in a clinical trial, you can talk to your medical oncologist to see if there is one suitable for you. Before you decide whether or not to proceed, you might like to discuss the risks and benefits with your doctor or clinical trial coordinator, and your family. Even if you decide that a clinical trial is not for you right now, you can continue to talk to your doctor about options that may be available for you in the future.
BCNA shares the vision of advocates around the world that all people with a diagnosis of metastatic breast cancer should have the option of discussing whether there is a clinical trial available to them when making treatment decisions.
The Australian Government has developed a clinical trials website to help people with all forms of cancer find trials. You can visit the website at australianclinicaltrials.gov.au.
The new edition of Hope & Hurdles has more information about clinical trials. To order your copy, even if you have received a previous edition, visit our website bcna.org.au or call us on 1800 500 258.