POPCaP/PATCH Program Dramatically Boosts Vet Clinical Trial Participation

The Department of Veterans Affairs (VA) has been able to “dramatically increase” clinical trial opportunities and participation in recent years, thanks in large part to a joint initiative from the Prostate Cancer Foundation (PCF) and VA, according to data presented at the 2025 ASCO Annual Meeting, held in Chicago, IL, May 30-June 3, 2025, and published simultaneously online.¹

According to the researchers, the PCF and VA worked together to create the Precision Oncology Program for Cancer of Prostate (POPCaP) within the VA Healthcare System, also known as PATCH, which strived to “bring cutting-edge clinical trials to veterans but also sought to develop careers for VA investigators and encourage clinical trial participation by a more diverse group of men.”

Under the initiative, PCF and VA-funded sites paid for genomic testing, established clinical trial infrastructure, created a budget working group, and hired a research nurse to help open complicated investigator-sponsored studies. They then followed up with regular monthly meetings to discuss research among the investigators and industry partners.

“Since the development of POPCaP/PATCH, veteran participation in clinical research has rapidly increased from 100 to 400 men enrolled in clinical trials. The number of clinical trials increased from 8 clinical trials to 21,” the researchers wrote, adding “using an existing database containing genomic results, it enrolled patients in trials requiring specific genomic mutations (e.g., MSI-H, BRCA2). We efficiently screened patients for clinical trials, and more than half of those screened enrolled in trials, 60%. Patients of different races and ethnicities participated- white 52.6%, black 36.1%, Hispanic/Latino 4.9%, Asian 2.2%, Native American 1.7%, unknown 2.5%.”

Data indicate that only about 7% of patients with cancer enroll in clinical trials.² The participation rate among veterans receiving care within the VA is estimated to be even lower, at approximately 2%. This discrepancy highlights the need for increased awareness and accessibility within the VA system, according to Daphne Friedman, MD, deputy director of the VA’s National Oncology Program, who spoke on this issue recently at the AMSUS 2025 meeting in National Harbor, MD.

Several barriers contribute to the low clinical trial participation rate among veterans. These barriers fall into 3 broad categories, according to Friedman, who outlined these barriers at the AMSUS 2025 meeting:

1. Patient-related barriers: Many veterans are unaware of clinical trial opportunities or do not know to inquire about them. A lack of knowledge often correlates with lower participation rates.
2. Provider-related barriers: VA oncologists may face challenges in identifying suitable clinical trials for their patients due to a lack of awareness or familiarity with trial options.
3. Systemic and institutional barriers: Veterans may have comorbidities that may exclude them from participation in certain studies, or their clinic or hospital may not be set up for the monitoring needed.

Increasing participation in cancer clinical trials within the VA system is critical for advancing cancer treatment and ensuring equitable access to innovative therapies for veterans, she said.³

References

1. Graff JN, Rettig M, Sanchez L, et al. Dedicated resources for veteran clinical trial participation: the Prostate Cancer Analysis for Therapy Choice (PATCH) program. J Clin Oncol. 2025;43:16.
2. Unger JM, Xiao H, Vaidya R, et al. Patient enrollment to industry-sponsored versus federally sponsored cancer clinical trials. J Clin Oncol. 2024;42:3917-3925.
3. Friedman D. Expanding access and curing cancer every day at VA. Presented at: 2025 AMSUS Meeting. March 3-6, 2025; National Harbor, MD.