The ever changing and evolving world of molecular-based clinical cancer research has created serious patient enrollment issues, explains D. Ross Camidge, MD, PhD, director of the Thoracic Oncology Clinical Program at the University of Colorado Cancer Center.

Camidge believes that finding patients with a sufficient level of a molecular abnormality is becoming difficult, especially as more is understood about heterogeneity. Moreover, geographical diversity adds further difficulty to adequate enrollment for trials that focus on treating one exact genetic abnormality.

Several online resources exist for distilling enrollment information, Camidge explains. The first preexisting resource mentioned is clinicaltrials.gov, which was recently redesigned to improve the discoverability of information. The website offers a search function and useful information on clinical trials but is not specifically geared toward patients.

Patient focused websites and online resources represent a budding and successful area for patient enrollment.

As an example, Camidge touts the success of the expert moderated forums provided by the Global Resource for Advancing Cancer Education (GRACE), founded by H. Jack West, MD. Early in the development of the ALK-targeted agent crizotinib, Camidge participated in a podcast with West that was very successful at providing information on the now approved agent.

As an earlier example of using the Internet for recruitment, Camidge describes the successes of the noted researcher George D. Demetri, MD, from the Dana-Farber Cancer Institute. Demetri used online resources for patient enrollment in a gastrointestinal stromal tumor trial, for which the National Institutes of Health did not believe he could find an adequate patient population.

Despite these successes there are still disconnects between the 21st century communication needed for enrollment and the 20th century methods of conducting trials. As a result, Camidge feels more needs to be done to improve how clinical trials are conducted with more of an emphasis on local laboratories and telemedicine. Additionally, Camidge notes that clinical trial locations need to be dispersed throughout the United States, rather than localized to urban centers.