Blog Entry: December 1, 2010
Were you aware that only around 3% of patients that are medically eligible participate in cancer trials in the US? Does this surprise you? I am from Australia and have been working with ENACCT as part of GlaxoSmithKline’s volunteer program (PULSE) for several months and I was surprised! I often assume because the US has a much larger population than ours it must be comparatively easier to accrue patients to trials. Not so! Even though the two countries are of similar land mass size, Australia’s population is approximately a tenth of the US, but surprisingly participation in cancer clinical trials is estimated to be around 6%, which is considerably lower than the UK participation rate of over 11%.
As I read the background literature I felt a strange sense of comfort as it highlighted recruitment and retention initiatives being implemented by sites in the US were virtually exact replicas of what was being done by Australian sites. So, the opportunity to be involved in a project focused on increasing accrual to cancer clinical trials with particular emphasis on minority groups and the underserved was definitely exciting and also inspiring with the prospect of identifying solutions that may impact locally in the US and potentially globally as well.
Why is this important? A Clinical Trial is considered the “gold” standard treatment for a patient diagnosed with cancer who is eligible to participate in a trial. With only 3% of the estimated 20% of patients who are medically eligible for trial participation, a large number of patients are not being offered the best treatment for their condition.
ENACCT’s project to improve accrual to cancer clinical trials is unique. It is based on a proven Quality Improvement methodology called a “Learning Collaborative”. As part of this framework we identified the best available evidence from the literature and mapped this to a pathway which would routinely be followed by a patient with cancer. In November, an Expert Panel meeting was held where we discussed the information we had gathered and enhanced this with further examples from the panel. The outcome was a package of evidence that has been vetted and improved by a group of experts in the field.
In 2011, the learning collaborative will be implemented by 6 sites in the US. The sites will use the evidence to select and implement strategies or efficiency improvements at their site. Data will be collected to determine if the strategy is making a difference over a pre-determined time frame. This information will then be shared amongst the sites and small changes made to see if greater improvements can be achieved. This process will continue over 3 cycles and will take approximately 12 months.
The overall aim of the collaborative is to increase accrual to cancer clinical trials especially among those from minority and medically underserved groups and that this information will assist sites around the US (and potentially globally). It has been a privilege to work with the team at ENACCT and the expert panel on this project and I am looking forward to the results of this exciting initiative in 2012!
Katrina Campion (ENACCT Fellow August – December 2010)