Financial Toxicity in Cancer Clinical Trials: An Issue in Need of Clarity and Solutions
Cet article examine l'effet des contraintes financières sur la participation aux essais cliniques des patients atteints d'un cancer et sur les caractéristiques socio-démographiques des participants, analyse les coûts non médicaux ainsi que les aspects éthiques et réglementaires associés puis détermine les approches susceptibles de réduire la toxicité financière liée à la participation aux essais cliniques
Today, almost half of US patients with cancer experience psychological stress related to the cost of treatment. As the cost of cancer care increases, patient co-payments and deductibles have risen. More than three quarters of people with cancer leave the workforce during their treatment, whereas more than one third spend their life savings within 2 years after diagnosis. This financial strain is greater among under-represented groups, which may lead to greater stress, reduced adherence to treatment, and worse outcomes for these populations. Despite potential benefits to the field and interest by individual patients, oncology clinical trials continue to struggle with low and delayed enrollment, as well as a lack of racial, ethnic, age, and socioeconomic diversity among trial participants. In particular, lower-income individuals are consistently less likely to participate. Considering the financial cost associated with clinical trial participation for patients with cancer, this disparity is not surprising. Together, these burdens and concerns related to affordability create financial toxicity for clinical trial participants and are recognized as an issue in cancer care more generally. Financial toxicity, as a mature research field with validated assessment tools, was recently highlighted in a special issue of JCO Oncology Practice.
Journal of Clinical Oncology , article en libre accès, 2025