In November, I co-authored an article in Oncology Practice Management with Randy Erickson, RN, MBA, Chief Executive Officer of Utah Cancer Specialists, Johnny Walker, Director of Research of Utah Cancer Specialists, and Linh Mekuria, MPA, clinical informaticist with XIFIN, Inc. The article, titled “Increasing Clinical Trial Participation in the Community,” explores the structural barriers to maximizing participation in clinical trials and proposes how to overcome them.
Clinical trials are invaluable for proving the efficacy of new therapies and determining novel treatment strategies to improve patient outcomes. Unfortunately, most clinical trials do not meet their enrollment targets. This is largely due to structural and clinical barriers.1 With up to 85% of oncology patients receiving treatment in a community setting, participation in cancer therapy clinical trials can be even more challenging.
Overcoming these barriers with a patient-centric, decentralized strategy
A common structural barrier to clinical trial participation is the lack of available trials in the patient’s area. A patient-centric, decentralized approach to clinical trials eliminates the need for patients to travel to the research site and is more representative of the larger population.2 A blended approach of traditional clinical trials with the support of telemedicine and the incorporation of new digital health tools can extend the reach of highly controlled clinical investigations to patients in the community setting.3
In addition to structural barriers, there is also the issue of clinical barriers. While treating oncologists strive to offer patients the most effective treatment options, there is often a lack of awareness of the existence of available, appropriate clinical trials. Implementing technology and analytics that bring together all aspects of the patient record, including molecular test results, can facilitate aggregate patient availability across the practice.
Read the full article and see an example of a dashboard to quickly identify eligible patients with colorectal cancer in Oncology Practice Management.
1 Unger JM, Vaidya R, Hershman DL, et al. Systematic review and meta-analysis of the magnitude of structural, clinical, and physician and patient barriers to cancer clinical trial participation. J Natl Cancer Inst. 2019;111:245-255.
2 US Food and Drug Administration. Advancing oncology decentralized trials. April 12, 2021. www.fda.gov/about-fda/oncology-center-excellence/advancing-oncology-decentralized-trials. Accessed February 3, 2022.
3 Khozin S, Coravos A. Decentralized trials in the age of real-world evidence and inclusivity in clinical investigations. Clin Pharmacol Ther. 2019;106: 25-27.