Edward S. Kim, MD, of Levine Cancer Institute at Atrium Health in Charlotte, N.C., chats with David H. Henry, MD, host of Blood & Cancer, about how to perform clinical trials in the community oncology setting.

Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, discusses a byproduct of our fragmented health care system – patients having to hear the same bad news repeated over and over.

Show notes 

• Only 3%-4% of adult oncology patients are enrolled in clinical trials.
• Most patients diagnosed with cancer are seen in community settings (as opposed to academic centers).
• Oncologists in the community setting face significant obstacles to enrolling their patients in clinical trials:
  • Communication between academic and community centers often is lacking, especially in more rural areas of the country.
  • Community-based oncologists usually are not compensated for time spent on research or academic work.
  • Treatment pathways used by many oncologists may not offer any information regarding clinical trials.
  • The traditional infrastructure of a community practice may not have the necessary experts to facilitate clinical trial participation.
  • Community oncologists may not feel comfortable talking to their patients about a novel drug of which they have little knowledge.
• How can community oncologists facilitate participation in clinical trials?
  • There must be a cultural change, starting with the organization’s leadership.
  • A study coordinator is crucial.
  • Data, finance, and regulatory individuals are likely required.
  • Coordination with pharmacy and pathology usually is necessary.
  • Electronically Accessible Pathways (EAPathways) is a tool developed by Dr. Kim’s team. It is available and allows any oncologist to input a patient’s information to determine if there is an appropriate clinical trial available.

Show notes by Sugandha Landy, MD, a resident in the department of internal medicine, University of Pennsylvania, Philadelphia

Dr. Kim can be reached at [email protected]

 

Additional reading

Patronik KE and ES Kim. A novel clinical pathways approach to delivering regional-based clinical trials and patient care in a hybrid academic- community-based system. J Clin Pathways. 2018 May;4(4):52-5.

Ersek JL et al. Implementing precision medicine programs and clinical trials in the community-based oncology practice: Barriers and best practices. Am Soc Clin Oncol Educ Book. 2018 May 23:38:188-96.

 

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Ilana Yurkiewicz on Twitter: @ilanayurkiewicz