Pediatric Cancer Clinical Trial Participation: Key Barriers

Key Takeaways

• • Black and Hispanic families showed strong willingness to participate in pediatric cancer clinical trials when offered the opportunity.
  • Trust in oncology teams and altruism were major facilitators of clinical trial participation.
  • About 73% of participating families reported household material hardship, including challenges with food, housing, transportation, or utilities.
  • Clinicians identified gatekeeping and assumptions about family participation as potential barriers to equitable trial enrollment.
  • Differences between parent and clinician perceptions suggest that providers may underestimate families’ willingness to participate.
  • Clear communication, consistent trial offers, and practical support may help improve equitable participation in pediatric oncology clinical trials.
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Pediatric Cancer Clinical Trial Participation Faces Equity Barriers

Pediatric cancer clinical trial participation remains uneven among historically marginalized populations despite strong willingness among Black and Hispanic families to participate, according to a study led by researchers at UT Southwestern Medical Center. Published in JAMA Network Open, the study examined parent and clinician perspectives to identify factors that support or hinder participation in pediatric oncology clinical trials.

What barriers affect pediatric cancer clinical trial participation?

The researchers surveyed 60 parents of Black and Hispanic children with cancer and 15 clinicians from Dana-Farber Cancer Institute. They also interviewed 20 parents and all 15 clinicians to understand experiences with research participation better.

The findings identified trust and altruism as important facilitators. Most parents reported high levels of trust in their oncology teams, and many expressed willingness to participate when clinical trials were offered.

However, several barriers may limit equitable participation. Parents and clinicians highlighted challenges associated with informed consent discussions and difficult-to-understand trial materials. These challenges may become more significant for families who do not speak English.

Household material hardship also emerged as an important consideration. About 73% of participating families reported challenges involving food, housing, transportation, or utilities. Clinicians viewed these hardships and the experimental nature of clinical trials as potential barriers, although parents did not identify them as major factors influencing their decisions.

How can clinicians improve equitable participation?

The study also identified clinician gatekeeping as a potential barrier. Clinicians may unintentionally limit access to trials when they make assumptions about a family’s willingness or ability to participate. Concerns about financial hardship and adherence to trial requirements may also influence whether providers offer clinical trials.

These findings highlight a gap between parent and clinician perceptions. Families may be more willing to participate than clinicians expect, suggesting that consistent trial referral and clearer communication could help reduce disparities.

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For pediatric oncologists, nurses, research coordinators, and other HCPs, providing understandable consent materials, addressing practical barriers, and offering clinical trials consistently may support broader participation.

Why does equitable pediatric oncology research matter?

Children from Black and Hispanic communities continue to experience disparities in cancer survival. Broader representation in pediatric cancer research can help ensure that clinical trial findings reflect diverse patient populations and may improve understanding of factors contributing to unequal outcomes.

The researchers emphasized that equitable pediatric oncology clinical trials require more than patient willingness. Healthcare teams and research systems must also address access barriers and avoid assumptions about who will participate.

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For HCPs involved in pediatric oncology, recognizing these differences between clinician expectations and family perspectives may help strengthen trust, improve trial access, and support more representative cancer research.

Source:

UT Southwestern Medical Center