Participating in clinical trials and receiving targeted therapy may negatively affect the economic status of patients with cholangiocarcinoma (CCA), according to a study recently published in the Journal of Surgical Oncology.

“We . . . need to increase clinical trial availability and eliminate the physical and financial barriers that threaten access and utilization of personalized and progressive therapies, especially as these investigations move to the first‐line setting,” the authors wrote.

This study included 208 patients; most of them (75%) had a diagnosis of intrahepatic CCA. The majority (57%) underwent surgical resection of the tumor, and 48% of them experienced recurrence of the disease. Almost a quarter of all individuals (22%) had enrolled in a clinical trial, and 29% received targeted therapy. 

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All participants completed 2 questionnaires regarding health-related quality of life, including the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) and the COmprehensive Score for financial Toxicity (COST).

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Patients who participated in a clinical trial and/or received targeted therapy showcased similar scores on the FACT-Hep test as those who did not, suggesting that participating in these therapeutic approaches does not affect quality of life, including physical, functional, emotional, and social well-being. 

However, individuals receiving targeted therapy and/or who were part of a clinical trial experienced higher financial toxicity than those who did not.

“Clinical trials are often only available at large, academic centers, creating a physical barrier to access and further compounding the socioeconomic challenges that are often prohibitive to clinical trial enrollment,” the authors explained. 

These results become even more eye-opening when considering the demographic and socioeconomic characteristics of the sample. For example, out of all individuals included in the study, 59% had private insurance, while 39% were under federal funding insurance. In addition, 60% had a bachelor’s degree or higher, while 41% and 39% had a current job or were retired, respectively. Finally, the majority (67%) had an income of $75,000 or more per year.


Keilson JM, Lindsey S, Bachini M, et al. Patient reported outcomes: financial toxicity is a barrier to clinical trials and personalized therapy in cholangiocarcinoma. J Surg Oncol. Published online July 15, 2022. doi:10.1002/jso.27012