{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:51:10Z","timestamp":1769165470207,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T00:00:00Z","timestamp":1596758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002618","name":"Aplastic Anemia and MDS International Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008884","name":"Edward P. Evans Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008884","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The development of novel therapies for the myelodysplastic syndromes (MDS) is hampered by inadequate trial recruitment. Factors contributing to low trial accrual are incompletely understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed a pooled patient database from institutions of the US MDS Clinical Research Consortium to compare the characteristics of participants in interventional trials with those of patients who did not enroll in a trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were identified for 1919 patients with MDS, and 449 of these patients (23%) participated in an interventional clinical trial. The median age of all patients was 68\u00a0years, and 64% were male. Patients who participated in trials were significantly younger than nonparticipants (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.014), and men were more likely to participate in a trial (71% of trial participants were male, whereas 61% of nonparticipants were; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Race and ethnicity were not associated with trial enrollment. Patients in more affluent ZIP codes had a higher participation rate (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Patients with intermediate\u2010 and high\u2010risk disease according to the revised International Prognostic Scoring System were overrepresented (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004), and trial participants less frequently had treatment\u2010related disease (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). In multivariable analyses, participation in a clinical trial was associated with a reduced hazard of death (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004). Even at large referral centers, only a minority of patients with MDS enrolled in interventional trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Restrictive trial eligibility criteria that exclude patients with MDS on account of age, comorbidities, or a history of another cancer are limit enrollment of MDS patients to clinical trials. Gaining insight into the barriers to trial accrual may help investigators and study sponsors to design trials that will accrue more rapidly and augment treatment options for patients with MDS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33105","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T20:09:06Z","timestamp":1596830946000},"page":"4735-4743","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Low participation rates and disparities in participation in interventional clinical trials for myelodysplastic syndromes"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4028-3733","authenticated-orcid":false,"given":"Charlotte K.","family":"Brierley","sequence":"first","affiliation":[{"name":"Weatherall Institute of Molecular Medicine Oxford United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily C.","family":"Zabor","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"},{"name":"Leukemia Program Taussig Cancer Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami S.","family":"Komrokji","sequence":"additional","affiliation":[{"name":"H. Lee Moffitt Cancer Center and Research Institute Tampa Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy E.","family":"DeZern","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail J.","family":"Roboz","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M.","family":"Brunner","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Stone","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Cancer Institute Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikkael A.","family":"Sekeres","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"},{"name":"Leukemia Program Taussig Cancer Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5130-9284","authenticated-orcid":false,"given":"David P.","family":"Steensma","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Cancer Institute Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181bd0445"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1878-0261.12465"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw413"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_156686"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21907"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774514558307"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002360"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31769"},{"key":"e_1_2_8_10_1","first-page":"56","article-title":"Recent advances in the cellular and molecular understanding of myelodysplastic syndromes: implications for new therapeutic approaches","volume":"16","author":"Brunner AM","year":"2018","journal-title":"Clin Adv Hematol Oncol"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-015-0269-y"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.8329"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-10-811729"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000293"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2008.005157"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2017.0007"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1978.10481571"},{"key":"e_1_2_8_18_1","unstructured":"National Institutes of Health. 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