Rapid Fire Best of the Best Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Current and future strategies in addressing the Unmet Need of Regional/Rural Early Phase Clinical Trials Access in Australia (#34)

Jordan E Cohen 1 2 , Rasha Cosman 1 2 3 , Jyoti Parmar 1 , Anthony Rodrigues 1 2 3 , Neha Aggarwal 1 4 5 , Anthony Joshua 1 2 3 , Jia (Jenny) Liu 1 2 3
  1. The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia
  2. Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
  3. Garvin Institute of Medical Research, Sydney, NSW, Australia
  4. Medical Oncology, The Canberra Hospital, Canberra, ACT, Australia
  5. Australian National University, Canberra, ACT

Background

Early phase clinical trials are primarily run conducted through specialist tertiary centres within major cities of Australia. However, 28% of Australian’s reside in regional and remote communities1. Multifaceted efforts are needed to ensure patients affected by cancer from all geographical backgrounds are offered opportunities for clinical trials within oncology. Previous data demonstrated equivalent survival and toxicity outcomes in clinical trials patients regardless of distance from the trial centre2. We undertook a retrospective study from patterns of referral to early phase trials at The Kinghorn Cancer Centre (TKCC) Phase 1 unit and the impact of telehealth and COVID-19 on phase 1 enrolment to provide education on the current models of trials.

Methods

Data was prospectively collected from all patients referred to TKCC Phase 1 unit from 2017 until data cut-off July 2024. Baseline demographics, prior history, geographic and trial enrolment data was captured. Data was analysed using SPSS v29.0.

Results

In total, 1625 patients were reviewed between January 2017 and July 2024. Mean age was 60.3±13.1, 91.8% were from NSW. Telehealth reviews were used for 32.2% of initial consultations. Telehealth use significantly increased for initial consultations after 2017-2019 (16.1% versus 41.7% from 2020 onwards, P<0.001). During the total period 28.6% of new patient consultations were from Australian Statistical Geography Standard (ASGS) 2-5 locations i.e. regional or remote. Regional or remote patients were more likely to use telehealth on new patients consultations versus ASGS 1 patients (51.7% vs 24.5%, P<0.001). 

Conclusion

This study highlights the ability to utilise telehealth within a phase 1 unit to ensure equitable recruitment to trials for regional and remote Australians. Integration of technology into decentralised trial models helps bridge regional oncology inequities. Further analyses exploring impact of regional/rural locality, type of trial enrolled and treatment outcomes for regional/rural participants will be detailed at the symposium.

  1. 1. Rural and Remote Health. Australian Institute of Health and Welfare. Available at: https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health (Accessed: 5 July 2024).
  2. 2. Lim, J. et al. (2022) ‘Impact of travel distance on outcomes for clinical trial patients: The Kinghorn Cancer Centre experience’, Internal Medicine Journal, 53(2), pp. 242–249. doi:10.1111/imj.15561.
  3. 3. Aggarwal, N. et al (2022), Impact of COVID-19 on early phase clinical trials recruitment and treatment in a major metropolitan Phase 1 Unit, Poster Abstracts. Asia-Pac J Clin Oncol, 18: 33-51. https://doi.org/10.1111/ajco.13856.