Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Enabling access to clinical trials for regional patients with cancer, an operational perspective from The Kinghorn Cancer Centre, St Vincent’s Hospital (#307)

Robert Kent 1 , Aaron O'Grady 1 , Chloe Martin 1 , Rasha Cosman 1 2 3 , Jordan Cohen 1 , Jia (Jenny) Liu 1 2 3 , Anthony Joshua 1 2 3
  1. St Vincent's Hospital, Darlinghurst, Darlinghurst, NEW SOUTH WALES, Australia
  2. Garvan Institute of Medical Research, Darlinghurst, NSW
  3. St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia

Background

The Kinghorn Cancer centre (TKCC) is in a unique position where a high proportion of regional/rural patients are referred to seek treatment options through participation in early phase clinical trials.1 Historic regional clinical referral pathways, in place for over 15 years has maintained close regional/rural collaboration with hospitals who do not have the infrastructure or capacity to run early phase trials. In order to support their participation, it has been necessary to adapt the trial processes to enable access and decrease the burden on the patients and families through a Decentralised Clinical trials (DCT) approach.

Methods:

We reviewed the operational approaches utilised to support regional/rural patients partaking in clinical trials at our site.

Findings:

In 2023, TKCC recruited over 120 patients into trials who live >200 km from the centre. Technological adaptations including electronic consenting (e-consenting) via video telehealth, electronic source documentation and remote monitoring were the most utilised strategies deployed in the post-COVID19 pandemic era to maintain engagement and recruitment of regional/rural patients to clinical trials at TKCC. Furthermore, TKCC established national vendors for the collection of health data and management and utilised vendor agreements. Communication with sponsors to allow for local assessments, vitals/ECGs and local bloods/imaging in order to reduce travel and time toxicity were met with universally favourable responses. Delivery of investigational product to allow treatment at home was permitted for stable patients during lockdown. Sponsor reimbursement for travel and accommodation to partake on early phase trials was also helpful however less financial supports were available for investigator-led clinical trials.

Conclusions:

Access to research treatment can be achieved for patients living in remote locations through technology, planning and operational logistics partners. Further adaptions are required to ensure central blood management, source documentation, safety and protocol compliance is maintained while supporting regional/rural patients with trial participation.

 

  1. 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.