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Improving Enrollment in Oncology Clinical Trials: Highlights from an Innovative Telemedicine Program

Improving Clinical Trial Enrollment Through Telemedicine

For oncology patients who have the right pathology and meet the appropriate inclusion criteria, clinical trials often provide the opportunity to benefit from therapies at the cutting edge of cancer medicine. The fact that participation in these studies contributes to improving care for future patients provides additional significance to the treatment experience for these patients. Indeed, most physicians and major societies – including the American Cancer Society — advocate for participation in clinical trials wherever appropriate.

Opportunities to participate in clinical trials come easily for patients who live near major academic centers as their oncology providers are frequently involved in trial design and execution. The story is quite different for those who are not fortunate enough to reside near academic centers. These patients are less likely to receive information about clinical trial opportunities and even when they do, the logistics associated with screening — including travel to trial centers and coordination of care between providers at different practices — can create significant barriers to trial enrollment and completion.

Recognizing these geography-related disparities in clinical trial participation, the medical oncology team at Keck Medicine of the University of Southern California has launched a telemedicine program through which patients in the community can access clinical trials. Led by Dr. Anthony Kim and Dr. Jorge Nieva, the program promotes close collaboration between the USC team and oncologists in the community to encourage screening for clinical trials using telemedicine. This innovative program offers numerous advantages to both patients and providers.

Dr. Nieva says, “The patient doesn't have to travel to Los Angeles to find out if they're eligible for a clinical trial. I'm sure it's very disheartening for patients to sit in LA traffic for an hour ... only to find out they're not eligible [for a clinical study].” Additional benefits include increased opportunities for family members to attend consultations from far away and direct incorporation of multiple providers into meetings.

The USC Norris team has made deliberate efforts to emphasize that the goal of the program is not to replace community providers in providing everyday care to oncology patients. The focus is really on assessing clinical trial eligibility and helping patients make decisions about trial participation. Dr. Nieva notes, "We will really focus on clinical trial eligibility, as opposed to providing opinions about what local doctors should be doing. In academia, our mission is to advance science ... not to be the care providers for all oncology patients - that's what the community oncologists are there for. We are not trying to take away their business. Patients don't benefit from receiving standard of care treatments away from their homes, but they do benefit from being part of clinical trials. We know that clinical trial patients on average do better, so we think there's an advantage to receiving tomorrow's medicine today:'

The USC Norris oncology telemedicine program was launched in lung cancer but has since expanded to other malignancies including melanoma, breast cancer, and genitourinary tumors. The program is open to all patients in California within and outside managed care networks. So far, approximately one-third of patients seen in telemedicine consultation have subsequently participated in clinical trials, with many receiving free medications through these studies that would otherwise have imposed significant financial strains on patients and their managed care networks. Importantly, plans are in place to study the impact of these telemedicine interventions on patient care. Dr. Nieva says, "We're going to be opening a study next year that will look at enrolling patients into clinical trials based on telemedicine screening visits, wearable sensor data, remote laboratory studies and CT scans, and home administration of drugs. This is something we are very excited about:'

The USC Norris Comprehensive Cancer Center at Keck Medicine of USC

USC Norris Comprehensive Cancer Center is a leader in the quest to make cancer a disease of the past. Our mission is to treat and prevent cancer by advancing and integrating education, research, and personalized patient care. As one of the eight original National Cancer Institute (NCI)-designated comprehensive cancer centers in the United States, USC Norris is one of the nation's preeminent academic medical institutions and one of California's top cancer centers.

We have been revolutionizing cancer research for more than 40 years with innovative surgical techniques and novel cancer treatments. Our nationally and internationally renowned physicians represent extensive areas of expertise, giving us the ability to provide truly customized care for our patients.

To refer a patient to an oncologist at Keck Medicine's USC Norris Comprehensive Cancer Center, please call (800) USC-CARE or (800-872-2273).