Using Prescreening as a Means of Increasing Oncology Trial Enrollment

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In light of cancer disparities, enrolling underserved patients in oncology treatment trials is essential. Sophisticated data mining tools have been used to increase enrollment that pairs patients with clinical trials; however, these tools may be unavailable and cost-prohibitive, particularly in public safety-net hospitals and healthcare systems.

A quality improvement program was implemented by the NYU Perlmutter Cancer Center Clinical Trials Office with the goal of expanding therapeutic trial enrollment at an affiliated public hospital, Bellevue Cancer Center (BCC). Using the electronic medical record, cancer registries, and conferences, 1 employee manually prescreened patients for the initiative with the objective of identifying eligible patients for therapeutic trials and those who subsequently enrolled.

A total of 31 patients were registered in therapeutic clinical trials at BCC during the 2-year period preceding the prescreening program. From July 2017 to July 2019, 255 patients were identified, of which more than half (56.1%) were enrolled in trials. Furthermore, 55 patients from the cohort who opted to enroll were referred to NYU for trials not available at BCC. This population of enrolled patients was diverse; of the 143 patients who were enrolled (median age, 55 years), >64% were female, 56% were non-white, and 57% were not English speaking, representing 16 languages. The top 3 disease groups were breast, gastrointestinal, and thoracic cancer, and 83% of the patients lived in low-income areas, with 62% in both low-income and health professional shortage areas.

A 4.6-fold increase in accruals resulted from designating a single employee to conduct screening, suggesting that in limited resource settings, therapeutic trial enrollment provides broader access to clinical trials for underserved populations.

Source:

Wu JJ, Yakubov A, Hay MMA, et al. Pre-screening as a tool for increasing oncology trial enrollment. Presented at: American Society of Clinical Oncology 2021 Annual Meeting, June 4-8. Abstract 1577.

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