I try to incorporate the clinical trial idea into the standard of care recommendation/discussion at the time of initial treatment decision making. After making a standard of care rx recommendation, I tell patients that my recommendation is based upon this treatment being the winner of a pr...

I tend to express clinical trials as a normal part of discussion. Using the same skills as in discussing hospice, I utilize the ASK-TELL-ASK or SPIKES model.   During my interview, I ask (Ask of ASK-TELL-ASK or P of SPIKES) patients what they know about their cancer, their treatment options, t...

Some additional thoughts relevant to clinical trials in the multi-modality, curative intent, initial management setting: 1. It is unbelievably helpful if the patient and family hear the same message about best standard option, best clinical trial option, and why the clinical trial seems like the be...

I discuss clinical trials as a potential treatment option after discussing a standard of care option. For some patients, standard of care isn’t an option. Usually in the first line setting, a trial drug (or placebo) is given in conjunction with standard of care, so the main downside is increas...

For patients in the metastatic settings where standard of care is approved and we have ample data of its efficacy and potential toxicity, I would definitely be in favor of delivering SOC first, and I will mention then that when/if this first line therapy fails, we have many other potential drugs in ...