Barriers to Optimal Care

Barriers to Optimal Care studies focus on understanding patient- and physician-specific barriers to accessing optimal care and identifying solutions to mitigate these barriers.

Non-small cell lung cancer is at the forefront of precision medicine—druggable mutations in 10 genes have been identified for adenocarcinoma and others are being discovered for squamous cell carcinoma. Targeted therapies, either already approved or under clinical investigation, exist for most of these mutations. In addition, immunotherapy and targeted therapies are being tested in clinical trials for small cell lung cancer. Biomarker testing is the first step toward access to precision medicine. However, physicians sometimes do not discuss or prescribe biomarker testing with/to their patients.

Another route to accessing lifesaving therapies is participating in clinical trials. For new treatments to get approved, it is essential that patients participate in clinical trials. in an iconic study conducted by Comis and colleagues, 33% of adult Americans reported that they would participate in a clinical trial if asked to do so. Despite these positive statistics, real-world participation in clinical trials is low. Only 3% of cancer patients participate in a clinical trial. The contribution of patient–related (lack of awareness and empowerment, lack of incorporation of patient-centric endpoints), physician-driven (hesitation to recommend trials, patient education), and industry/investigator-initiated (restrictive inclusion and exclusion criteria, lack of transparency in data sharing) barriers to this low rate of participation cannot be underestimated.

Projects include: