Identifying patient values impacting the decision whether to participate in early phase clinical cancer trials: A systematic review

Liza G.G. van Lent*, Lea J. Jabbarian, Jelle van Gurp, Jeroen Hasselaar, Martijn P. Lolkema, Julia C.M. van Weert, Carin C.D. van der Rijt, Maja J.A. de Jonge

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)


Background: For many patients with advanced cancer, the decision whether to participate in early phase clinical trials or not is complex. The decision-making process requires an in-depth discussion of patient values. We therefore aimed to synthesize and describe patient values that may affect early phase clinical trial participation. Methods: We conducted a systematic search in seven electronic databases on patient values in relation to patients’ decisions to participate in early phase clinical cancer trials. Results: From 3072 retrieved articles, eleven quantitative and five qualitative studies fulfilled our inclusion criteria. We extracted ten patient values that can contribute to patients’ decisions. Overall, patients who seek trial participation usually report hope, trust, quantity of life, altruism, perseverance, faith and/or risk tolerance as important values. Quality of life and humanity are main values of patients who refuse trial participation. Autonomy and social adherence can be reported by both trial seekers or refusers, dependent upon how they are manifested in a patient. Conclusions: We identified patient values that frequently play a role in the decision-making process. In the setting of discussing early phase clinical trial participation with patients, healthcare professionals need to be aware of these values. This analysis supports the importance of individual exploration of values. Patients that become aware of their values, e.g. by means of interventions focused on clarifying their values, could feel more empowered to choose. Subsequently, healthcare professionals could improve their support in a patients’ decision-making process and reduce the chance of decisional conflict.

Original languageEnglish
Article number102217
JournalCancer Treatment Reviews
Publication statusPublished - 1 Jul 2021

Bibliographical note

Funding Information:
This research was sponsored by the Dutch Cancer Society (grant number: KWF11086). The funder had no further role in the design of the study, nor in the drafting and revision of the manuscript.

The authors wish to thank Maarten F.M. Engel from the Erasmus MC Medical Library for developing and conducting the search strategy in multiple databases.

Publisher Copyright:
© 2021 The Author(s)

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.


Dive into the research topics of 'Identifying patient values impacting the decision whether to participate in early phase clinical cancer trials: A systematic review'. Together they form a unique fingerprint.

Cite this