From the blog

Pleural Mesothelioma Study Recruitment Challenges

Published: June 14, 2024

Pleural mesothelioma is a cancer of the lining of the lungs called the mesothelium. It is both rare and aggressive and is linked to asbestos exposure. Patient survival is poor and there are limited treatment options for this cancer. A new study known as MARS 2 looked at surgery alongside chemotherapy to see if surgery could improve survival.

It can be hard to recruit for clinical trials. This is especially true for studies looking at surgery compared to non-surgery. This was the case for the MARS 2 study. The MARS 2 study faced multiple challenges when trying to recruit patients. One problem was that patients were getting mixed advice from doctors, making the recruitment process hard. Doctors’ biases also influenced their willingness to refer patients. This affected recruiting practices and informed consent. Another problem is that patients had to choose between surgery and chemotherapy, which is a hard decision without being completely informed. To get around these issues, the MARS 2 study used QuinteT Recruitment Intervention (QRI). This strategy uses qualitative and quantitative data to get past barriers.

Randomized Controlled Trials are important parts of the cancer treatment process. They give reliable evidence on new treatments’ effectiveness and safety. They work by randomly assigning participants to treatments, which helps reduce bias. This helps ensure study outcomes are from the treatments, not other factors. Randomized controlled trials also allow direct comparisons for treatments. This allows researchers to see what treatments work best and can allow definitive decisions to be made on treatments. Randomized clinical trials also allow new care standards to be created. New treatments would not be possible without clinical trials since safety and effectiveness are confirmed through testing. We would not have the treatments we have today without clinical trials.

The MARS 2 study used different recruitment techniques to get around recruitment issues. The first thing it did was train clinicians. This helped to raise awareness and improved their ability to get patient consent as well as make referrals. Secondly, the study emphasized clinical equipoise, which is the need for real uncertainty in treatment choice. This helped doctors present the study neutrally to patients. Finally the study used a mixed method approach via the QRI. This helped to tailor strategies to each barrier, allowing the barriers to be quickly and effectively resolved.

Recruitment for the MARS 2 study was a tough endeavor, but it was successful. This shows the need for personalized support and strategic interventions in complex randomized clinical trials. Trials like this are essential in the understanding of complex and hard to treat diseases like mesothelioma. They improve treatments and improve lives. Without these clinical trials, we would not have the treatments we have today for the management of hard-to-treat cancers like mesothelioma.

Nikola Mills et al., “Strategies to address recruitment to a randomised trial of surgical and non-surgical treatment for cancer: results from a complex recruitment intervention within the Mesothelioma and Radical Surgery 2 (MARS 2) study” BMJ Open May 1, 2024). [Link]
Contact Us
Have you received a diagnosis? *