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President's Theme 2020-2021

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Randall A. Oyer, MD, was named the Association of Community Cancer Centers (ACCC) President for 2020-2021 at the ACCC 46th Annual Meeting & Cancer Center Business Summit held March 4-6 in Washington, D.C.

ACCC invites each president to select a theme for their year in office that addresses a timely issue in cancer care through the creation of programs and resources. Dr. Oyer announced that the theme of his presidency will be “Community Oncology Can Close the Gap in Cancer Research.”

“Over the past year ACCC has heard from our members that there are gaps in community research,” said Dr. Oyer. Respondents to ACCC’s “2019 Trending Now in Cancer Care Survey” identified their top three challenges to offering patients with cancer clinical trials as staff resources and training (53%), program infrastructure (50%), and lack of patient understanding of the clinical trials process (46%). Citing these survey findings, Dr. Oyer remarked: “We have a serious imbalance in our clinical trials work. Our patients are in the community, yet the trials are at academic medical centers. And I believe that ACCC is uniquely situated to close this gap.”

Among the plans to achieve this goal outlined by Dr. Oyer were the following:

  • Creating a multidisciplinary taskforce to identify staff/program/patient education resources needed to accelerate implementation of clinical trials in ACCC member practices and programs
  • Bringing together experts at the 2020 ACCC Institute for the Future of Oncology forum to share best practices and learn more about challenges and barriers to clinical trials adoption
  • Developing a series of articles, blogs, and podcasts on effective practices in clinical trials accrual and management.

“We would like to improve our care and access for traditionally underserved communities. We would like to increase sensitivity, awareness, and understanding of the needs specific to geriatric oncology. And we would like to bring precision medicine into the community by understanding how to use the new precision diagnostics and radiology techniques to make sure that our patients have access to these services.”

The resources and tools that will be developed in conjunction with Dr. Oyer’s President’s Theme will be posted to this webpage as they are available.

From Oncology Issues

jf21-cover-141x190Community Oncology Can Close the Gap in Cancer Research
By Amanda Patton

Although multidisciplinary cancer care is synonymous with access to cutting-edge treatment options, including clinical trials, improving nationwide patient participation remains a challenge. Learn how this large independent oncology practice in northwest Arkansas grew its research program to offer patients access to phase I, II, and III trials in the communities where they live and work.

 

Cancer Center Brings Clinical Trials to Diverse Population


October 06, 2020
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While the pandemic continues to disrupt the conduct of cancer research, clinical trials remain crucial to advancing clinical care and providing the latest treatment options to all patients, including those in medically underserved communities. Given its location in the American southwest, Yuma Regional Medical Center (YRMC) Cancer Center has a long history of providing culturally appropriate care for its largely Hispanic population. The cancer center’s strong research program enabled it to offer its patients early access to COVID-19 trials that were not available to patients in most of the country.

Located in the southwest corner of Arizona, where the border intersects with California and Mexico, YRMC Cancer Center is a not-for-profit, sole community provider that serves nearly 205,000 people, many of whom have low incomes. More than half of the patients the cancer center sees are covered by Medicare (49.9%) or Medicaid (26.4%).1 Barriers to healthcare for much of this population have always been a concern, says Abhinav Chandra, MD, medical director of YRMC Cancer Center and Institutional Research.

“Providing screening and access to care have always been a challenge in this particular border town,” explains Dr. Chandra. “The ratio of doctors to patients is very low, so we are federally designated as a medically underserved area.” One of YRMC Cancer Center’s primary focuses is on improving access by enabling enrollment into clinical trials, which can provide treatment options otherwise unavailable to most patients.  

While disparities in cancer care and access to clinical trials are not new, the pandemic has underlined the need to address them. Healthcare organizations are increasing their collaborative efforts to find new ways to expand access to clinical trials among underrepresented groups. YRMC Cancer Center is forging a path from which others can learn.

Partnering for Access

As COVID-19 made its way to Yuma, the Institutional Research Department at YRMC Cancer Center was watching and waiting. “The pandemic in Yuma came a little late,” says Dr. Chandra. “We were seeing what was happening across the nation, especially in New York, and before that, in Italy and China. That gave us time to open some relevant clinical trials.”

Many patients with cancer are immunocompromised and at high risk for viral infections, so Dr. Chandra and his team at YRMC Cancer Center planned early for how they would manage treatment for their patients who contracted COVID-19. At the same time, the Mayo Clinic, through the Food and Drug Administration's (FDA’s) expanded access program, had begun the first clinical trials investigating the efficacy of convalescent plasma as a treatment modality for COVID-19.2 YRMC partnered with Mayo to help conduct those trials.

“In Yuma, even our very first patients with COVID-19 who came to the hospital in April were able to get convalescent plasma through our partnership with Mayo,” says Dr. Chandra. “We were able to open the Expanded Access Program and give our patients very relevant treatment options right from the beginning.” Patients also were able to receive remdesivir through the FDA’s Emergency Use Authorization.

Building Trust

Dr. Chandra notes that trust is perhaps the most critical factor in ensuring the inclusion of patients from varying social, cultural, and racial backgrounds in clinical trials. YRMC Cancer Center works hard to build trust from within its community by cultivating a deep understanding of the patients it serves. Some successful strategies YRMC Cancer Center has used in recruiting for clinical trials include:

  • Enabling shared decision-making between patients and their providers by employing certified, in-person translators and validated translation services. At YRMC Cancer Center, family members never serve as a patient’s sole translators.
  • Integrating bilingual social workers and nurse navigators into patient care
  • Enabling social workers and nurse navigators to continually conduct outreach activities to increase awareness about clinical trials and reduce the fears and stigmas associated with them
  • Providing culturally and linguistically sound educational resources for both patients and caregivers to help increase their understanding of clinical trials
  • Partnering with community organizations on patient outreach efforts, such as helping provide transportation
  • Enabling seamless patient access to multilingual telehealth and virtual health services
  • Ensuring consent forms are available in multiple languages and formats at the beginning of clinical trial enrollment periods

Building a Research Team

A commitment to continually analyze metrics and apply strategies to minimize errors and improve processes has directly improved patient experience, quality of care, financial stability, and overall growth at YRMC Cancer Center. In 2016, YRMC centralized all of its research activities under one umbrella by hiring a Director of Institutional Research. Since then, the cancer center’s research department has been able to grow its portfolio of clinical trials and grants. This has enabled YRMC Cancer Center to subsidize additional staff, including two clinical research associates, one clinical research assistant, and one research program financial analyst.

Physicians in underserved communities have a “moral responsibility to ensure equitable cancer care for every patient,” Dr. Chandra says. He affirms that the team at YRMC Cancer Center will continue to expand clinical trial access to its community and provide a roadmap for other communities to follow.

References

  1. Yuma Regional Medical Center. Patients Come First: 2018 Report to the Community.
  2. The Mayo Clinic. EAP for Convalescent Plasma no Longer Enrolling; The FDA Authorized Emergency Use. Oct. 5, 2020.

You also may be interested in

  • Access an on-demand replay of a webinar exploring strategies for sustaining clinical trial programs during COVID-19 and increasing the relevance of research to vulnerable and underserved populations.
  • In July 2020, the American Society of Clinical Oncology (ASCO) joined ACCC to announce a new collaboration to promote clinical trials in cancer programs with racially diverse communities. The joint initiative is designed to identify and implement novel strategies and practical solutions to increase the participation in clinical trials of groups underrepresented in cancer research.

 

 

 

Clinical Trial Resources

  • Virtual Navigation to Clinical Trials
    Jan 4, 2019

    In the current oncology clinical trials landscape, many barriers remain to clinical trial enrollment that affect both the oncologist and the patient. Among these are trial locations, strict eligibility requirements, insufficient resources to support appropriate clinical trial education and screening, as well as patient and provider attitudes about trials.

  • IO Trials Are Accruing: Where Are the Patients?
    Sep 10, 2018

    Research nurse Joannne Riemer, RN, BSN,  started her position at Johns Hopkins Medical Institution in 2010. Within six months, she was working with checkpoint inhibitors. From her vantage point in clinical trials research, she discusses the many changes in IO clinical trials patient selection over the last eight years. 

Podcast

  • [PODCAST] Episode 10: The Immunotherapy Patient Perspective
    Jan 15, 2020

    We sat down with journalist Mary Elizabeth Williams, one of the first patients treated with combination immunotherapy, to discuss her experience as an IO patient and how to bridge communication gaps among patients, doctors, and researchers.

COVID-19 Resources

HHS-60x60combatCOVID.hhs.gov provides important information and links to access the most current treatment guidelines and inpatient and outpatient clinical trials.

Live and On-Demand Webinars