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Semin Neurol 2024; 44(01): 047-052
DOI: 10.1055/s-0043-1777421
Review Article

Evolving Barriers to Clinical Trial Enrollment and Clinical Care in Neuro-oncology in the Face of COVID-19

Nikhil Grandhi
1   Division of Oncology, Department of Medicine, Siteman Cancer Center, Washington University in Saint Louis, St. Louis, Missouri
,
Alice Y. Zhou
1   Division of Oncology, Department of Medicine, Siteman Cancer Center, Washington University in Saint Louis, St. Louis, Missouri
,
Margaret O. Johnson
2   Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina
,
Omar H. Butt
1   Division of Oncology, Department of Medicine, Siteman Cancer Center, Washington University in Saint Louis, St. Louis, Missouri
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Abstract

The lack of treatments with durable response in neuro-oncology highlights the critical need for clinical trials to advance patient care. The intersection of relatively low incidence, evolving classification schema, and entrenched community, healthcare provider, and organizational factors have been historic challenges against successful trial enrollment and implementation. The additional need for multidisciplinary, often tertiary-level care, further magnifies latent national and international health inequities with rural and under-served populations. The COVID-19 pandemic both unveiled fundamental weaknesses in historical approaches and prompted the necessity of new approaches and systems for conducting clinical trials. Here, we provide an overview of traditional barriers to clinical trial enrollment in neuro-oncology, the effect of COVID-19 on these barriers, and the discovery of additional systemic weaknesses. Finally, we discuss future directions by reflecting on lessons learned with strategies to broaden access of care and streamline clinical trial integration into clinical practice.

Keywords

neuro-oncology - clinical trials - barriers - COVID-19 - inequities


Publication History

Article published online:
29 December 2023

© 2023. Thieme. All rights reserved.

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