As experimental oncology therapies become increasingly complex, institutions like the Cleveland Clinic are adapting to meet the demands of early-phase clinical trials. One innovative step has been the creation of the Novel Therapeutics Clinic (NTC), designed to streamline care for patients participating in phase 1 and 2 clinical trials. At the center of this transformation is Shannon Perkins, APRN, MSN, AOCNP, who serves as the clinic’s only full-time advanced practice provider (APP) and point person for clinical care and operational processes.
Mayo Clinic’s Clinical Trials Beyond Walls initiative is redefining the future of research participation by enabling decentralized capabilities in clinical trials. Spearheaded by medical director Tufia Haddad, MD, and research administrator Rebecca Kottschade, MA, PMP, this visionary program prioritizes patient access, equity, and flexibility by delivering a new approach to trial engagement.
As the role of clinical research continues to expand in oncology, many community cancer centers are seeking efficient, compliant ways to integrate clinical trials into routine care. For programs using Epic as their electronic health record, Epic’s Research Module is a powerful tool kit to support this goal—bringing trials closer to patients and reducing administrative burdens for staff.
On a Saturday during football season, tensions run high as Big Ten universities face off against each other, but every other day of the week, clinicians and scientists across various Big Ten schools work together to bring cancer treatments closer to patients, as part of the Big Ten Cancer Research Consortium (Big Ten CRC). Founded in 2013, the idea for the Big Ten CRC arose during a meeting of cancer center directors, when Steven Rosen, MD, former director of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, realized the potential of the Big Ten Conference and its member institutions—10 of which were National Cancer Institute (NCI)–designated cancer centers at the time—to transform cancer research through collaboration. When Dr. Rosen presented this idea to the other Big Ten cancer center directors, he was met with enthusiastic support and thus the Big Ten CRC came to life. By leveraging the scientific and clinical expertise of Big Ten universities, the Big Ten CRC aims to “drive science rapidly from ideas to treatment and prevention.”
Clinical trial accrual rates continue to struggle postpandemic despite various efforts and initiatives to expand access and enhance participation. During the pandemic, research programs across the country were temporarily paused or shut down as the world shifted its focus to fighting COVID-19 and minimizing in-person contact. Moreover, research sites suffered from a significant loss of personnel as nurses were diverted to the care of patients with COVID-19 and others retired or changed positions. Ultimately, the pandemic drastically impacted accrual rates. To combat these repercussions, the NCI Division of Cancer Treatment & Diagnosis launched its Virtual Clinical Trials Office (VCTO) Pilot Program in 2023 to address the ongoing research staffing shortages.
While many providers look at community cancer centers and see hurdles to clinical trial participation, Victor Lin, MD, PhD, sees opportunities. He joined Mary Bird Perkins Cancer Center as its research medical director 3 years ago after running clinical trials at a large academic center. The program has grown under his leadership through implementation of specialized staff, educational initiatives, and community collaboration. While many community cancer centers that offer clinical trials are limited to observational studies, Mary Bird Perkins offers interventional studies to its patients, with arms of the same trials that can be found at large academic centers in neighboring states. Notably, 21% of its clinical trial enrollment comprises patients from minority populations, well above the national average. Lin attributes much of this success to the strengths of a small institution, saying, “community cancer centers are actually better positioned than academic centers to take the lead on enrolling to clinical trials.”
Entry-level clinical research positions, such as the clinical research specialist (CRS) position used at Duke University, serve as an important entry point into the field of clinical research and an essential role for building early talent; however, these positions are often difficult to come by. In most cases, principal investigators and other hiring managers are incentivized to recruit for experienced clinical research coordinators (CRC) with more extensive qualifications, rather than entry-level positions. A CRC at Duke typically requires a bachelor’s degree with no additional work experience or an associate degree with 2 years of related experience, whereas a CRS requires an associate degree with no additional work experience. This leaves early career professionals, or those who would like to transfer careers into clinical research with an associate degree and no related work experience, in a tough position; they need jobs that allow them to build work experience, yet these jobs are not available. While the job details here are specific to Duke, the situation is not. Career seekers and training programs alike suffer from this catch-22.