Understanding the Barriers to Pediatric Oncologist Engagement and Accrual to Clinical Trials in National Cancer Institute-Designated Community Oncology Research Programs

JCO Oncol Pract. 2020 Oct;16(10):e1060-e1066. doi: 10.1200/JOP.19.00707. Epub 2020 May 12.


Purpose: Clinical trial participation leads to progress in cancer care. Principal investigators (PIs) and clinical research associates (CRAs) play key roles in the provision and maintenance of clinical trial portfolios at their sites. Previous studies have evaluated the educational and resource needs of adult oncology providers, but nothing to date has focused on providers of pediatric oncology care. We aimed to identify the educational needs and clinical trial participation barriers at National Cancer Institute Community Oncology Research Program (NCORP) Children's Oncology Group (COG) sites to improve the quality of site investigator engagement.

Methods: Quality improvement surveys of pediatric clinical research staff at NCORP sites were performed. The first was a web-based inquiry of NCORP COG PIs and lead CRAs to assess their general understanding of NCORP organizational structure and needs. The second survey of COG PIs was conducted by one-on-one telephone interviews aimed at identifying specific barriers to physician engagement and patient enrollment in clinical trial research.

Results: The majority of NCORP COG PIs and CRAs (63%) reported an incomplete understanding of NCORP structure, with approximately half expressing interest in developing stronger collaborations and engagement. Most NCORP COG PIs reported at least one shared barrier to clinical trial enrollment (78%), with inadequate protected time and research support (39% each) being the most frequently cited barriers.

Conclusions: Contributions to pediatric cancer clinical research at COG NCORP sites could be enhanced through improved education, resources, and time allocation.

MeSH terms

  • Adult
  • Child
  • Clinical Trials as Topic*
  • Health Services Research
  • Humans
  • Medical Oncology*
  • National Cancer Institute (U.S.)
  • Neoplasms* / therapy
  • Oncologists*
  • United States