The Faces of Financial Toxicity: A Qualitative Interview Study of Financial Toxicity in Advanced Cancer Patients in Phase I Oncology Trials

Objective: To characterize the financial toxicity experienced by advanced cancer patients enrolled in phase I oncology trials. Patients and Methods: We conducted structured interviews with cancer patients participating in phase I clinical trials. Using a thematic analysis approach, we identified recurring themes in patients’ experiences of financial toxicity resulting from trial participation. Results: Seven major themes emerged from the interviews: (1) the burden of travel, (2) a willingness to pursue treatment despite financial risk, (3) fear of destitution, (4) financial toxicity equaling physical toxicity, (5) changes in food spending, (6) reluctance to confide in the study investigator about financial toxicity, and (7) difficulty navigating financial aid. These themes highlight the multifaceted financial challenges faced by patients in early phase clinical trials and the need for targeted support services. Conclusion: Our findings underscore the relevance of financial toxicity in the context of phase I clinical trials and provide insights into the diverse challenges faced by advanced cancer patients. These challenges likely augment the disparities seen in trial enrollment for historically marginalized populations. Addressing financial toxicity in this population is crucial for improving patient outcomes and quality of life. Future research should focus on developing effective interventions and support services tailored to the needs of patients in early phase clinical trials.