Abstract 2594: clinical pathways as a platform to support clinical research
Ellis PG. Abstract 2594: Clinical pathways as a platform to support clinical research. Cancer Research. 2016;76(14 Supplement):2594-2594. doi:10.1158/1538-7445.am2016-2594.
Clinical trials are essential to advancing cancer care; however, actual patient accrual rates generally fall well below the Institute of Medicine's stated goal of 10% of all newly diagnosed patients. To support the goal of increasing clinical trial accruals, Via Oncology (VO) uses its clinical pathways decision support tool (Via Portal or VP) to promote awareness of locally available clinical trials and provide associated analytics for its cancer center (CC) customers.
VO works continuously with each cancer center to identify and embed their CC specific clinical trials in the applicable disease within the VP. In their daily practice, providers navigate the VP by entering information about each patient's specific state and stage of disease. If a clinical trial is locally available anywhere within the CC's network, that trial is presented as the first treatment recommendation before any standard of care pathway recommendations. Links to trial specific documents are also presented. If the provider feels the patient might be appropriate for that trial, a secure email notification is generated for the trial coordinator. If the patient is not accruing to the trial, the provider must select the reason for non-accrual from a structured list of reasons. Additionally, the VP can be interfaced with trial management systems for timely opening and closing of trials within the VP.
Data captured in the VP for the twelve months ended October 31, 2015 was retrospectively analyzed to calculate accrual rates for patients potentially eligible for a clinical trial. The distribution of reasons for not accruing patients to clinical trials was also calculated and analyzed.
During this time period, 10,000 patients had a high level
clinical presentation that matched an open clinical trial embedded in the VP
(the patients were not specifically matched for trial inclusion/exclusion
criteria). Of the total, 1,391 (13.9%) of patients were documented as accrued to a clinical trial. A total of 9,661 reasons for not accruing the patient to a trial were captured and distributed as follows: patient not eligible (34.4%), patient not interested (14.7%), patient accrued to other trial (0.8%), financial burden or insurance does not cover (0.5%), trial not available at site (25.6%), trial already selected (0.8%), other reason(23.2%).
VP also acts as a tool to promote clinical trial accruals and measure reasons for non-accruals. The reasons for not accruing provide insight to the barriers to accrual that patients and practices face. Additional reasons could be defined in the future to reduce the incidence of other non-defined reasons.