(UroToday.com) The 2025 AUA annual meeting featured a prostate cancer session and a presentation by Dr. Madison Krischak discussing access to prostate cancer clinical trials in the VA and whether veterans with prostate cancer are scientifically underserved. Clinical trials advance science and provide innovative care that is often the only option for some cancer patients. However, certain groups, such as Veterans with prostate cancer, may lack access to these trials and be considered “scientifically underserved.” It remains unclear how frequently and where prostate cancer trials are offered within the VA healthcare system. As such, describing these gaps could highlight opportunities to improve Veteran access to clinical trials and ensure they benefit from trial participation. To understand these gaps, Dr. Krischak and colleagues analyzed VA site inclusion in prostate cancer trials listed on ClinicalTrials.gov.
This study identified all phase 2-3 prostate cancer clinical trials registered on ClinicalTrials.gov after January 2007 and extracted trial site information. A custom algorithm identified VA sites recorded on ClinicalTrials.gov, and they calculated the number of unique trials at each VA by trial phase and overall status. Using the VA directory, they then grouped VA hospitals by unique address and removed duplicates. Dr. Krischak also determined the proportion of VA sites hosting at least one clinical trial and the proportion of trials with at least one VA site. Finally, they analyzed geographic variation in trial availability by examining the proportion of VA facilities in each census division with at least one prostate cancer trial.
Of 1,884 registered phase 2 or 3 prostate cancer trials, 118 (6%) included a VA site. For phase 3 trials, 55 of 353 (16%) included at least one VA site. Among 159 VA facilities, 66 (42%) have had at least one phase 2 or 3 trial, and 58 (36%) hosted a phase 3 trial. As of March 2024, 53 VA sites (33%) had an active phase 3 trial, 60 (38%) had an active phase 2 or 3 trial, and 8 sites (5%) had >10 active trials:
Trial availability varied by region, from 3 of 10 VA facilities in New England (least) to 10 of 19 in the Pacific division (most):
Dr. Krischak concluded her presentation discussing access to prostate cancer clinical trials in the VA and whether veterans with prostate cancer are scientifically underserved with the following take home points:
- Veterans treated at VA facilities have access to only 6% of prostate cancer clinical trials
- Further, less than half of VA hospitals have at least one prostate cancer clinical trial, and only a third have had a phase 3 prostate cancer clinical trial
- There was a higher proportion of Pacific division VA facilities offering trials than New England or Middle Atlantic divisions
- These findings indicate that Veterans may be underserved in prostate cancer clinical trial access, highlighting the need for strategies to increase trial availability within the VA
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 American Urological Association (AUA) annual meeting held in Las Vegas, NV, Saturday, April 26 - Tuesday, April 29, 2025
Related content: Clinical Trial Access Barriers for Veterans with Prostate Cancer - Madison Krischak