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Triumphs in Trials: A Spotlight on Cancer Clinical Trials Across the Organization
Clinical trials specifically for cancer care first occurred in 1955 and focused on patients with acute leukemia.¹ Since the 1950s, clinical trials have advanced and improved, resulting in more targeted treatments and therapies for various cancer diagnoses. These instrumental clinical trials provide lifesaving opportunities for cancer patients who face a challenging journey to health and are beneficial to patients whether it is delivered through a large hospital system or community practice.
Having care options, including clinical trials, available locally makes a difference in the patient’s health outcomes. Currently, there are more than 140,000 clinical trials in the United States as of June 2023.² However, there are still barriers that hinder many patients from seeking out and enrolling into the trials, and this is found across all medical disciplines. Common barriers to enrollment are patient perceptions as well as patient eligibility. Other barriers keeping patients from enrolling include misinformation about a trial or not knowing of trial opportunities that are available, inaccessibility that comes with enrolling in a trial (such as travel time and costs among other tradeoffs), being in the placebo group and fear that the trial is a “last-ditch effort.”³
As a leader in healthcare and specifically oncology, AON is committed to cancer research and expanding access to clinical trials to ensure equitable patient care.⁴ Many AON practices are active research sites, including four that are strategic research sites for the Sarah Cannon Research Institute and six that offer diverse clinical trials to their patients. Additionally, the practices across the network have collectively more than 100 active clinical trials.
AON further builds upon the goal of closing the cancer care gap through the Research Committee, which is dedicated to “serv[ing] the AON partner practice’s mission of providing patient access to community-based, oncology clinical trials through shared expertise and innovative research processes.” The committee is comprised of AON leaders and physicians across the network and works to ensure equitable access to clinical trials for all AON patients is available and that practices have the support they need to either deliver trials themselves or enroll patients into trials in the area. Current initiatives of the committee include developing an organic research network within AON, helping more practices become research sites including providing the support and guidance needed to be successful, and mentoring interested groups to develop new capabilities or grow capabilities in the sites already doing research.
“AON can help lay the groundwork for community practices to begin administering clinical trials,” said AON’s Vice President of Clinical Research Katie Goodman.
“Whether practices need financial assistance or tech support related to trials, AON has the resources that allow physicians and their practices to become research sites or strategic research sites for our partner the Sarah Cannon Research Institute. This is only one benefit of being part of this growing network of community oncology practices.”
To effectively build a successful clinical research program, Dr. Ralph V. Boccia from The Center for Cancer and Blood Disorders in Bethesda, Maryland, and active member in the AON Research Committee recommended two considerations:
• Decide first whether the practice really wants to do clinical research. “This is a huge commitment that can be rewarding for patients, staff and doctors,” Dr. Boccia explained. “However, it requires the development of an infrastructure to support the program.”
• Then, employ and retain dedicated staff focused on the clinical research program. Dr. Boccia continued to share that a program of this caliber requires staff who are qualified and equipped to find and recruit patients into the program. These individuals also need to be able to effectively inform the patient about the trial, then gather consent from the patient and monitor those in the program closely. Additionally, this specific staff needs to be able to assess the efficacy and safety of the program, host regular key practice stakeholder research meetings, report on the program’s data and occasionally present findings at appropriate meetings and host sponsor monitoring.
Dr. Boccia is experienced in the vertical of clinical trials — leading the practice’s clinical research program that has been operating for 20 years. “We are approached daily with new trial opportunities,” Dr. Boccia said. “We are authors on abstracts at ASH (American Society of Hematology) and ASCO (American Society of Clinical Oncology) every year and have appeared in publications of major hematology and oncology journals.” Dr. Boccia himself has penned over 180 publications centered on clinical trials.
When asked for examples of how The Center for Cancer and Blood Disorders is involved in clinical trials, Dr. Boccia said, “We have been a part of developing many of the new drugs and therapies we use in clinical practice today and are a part of new therapies just approved or about to be approved. Examples are Avastin, Abraxane, Tagrisso, Revlimid, Pomalyst, Nplate, Optivo, Yervoy, Keytruda, Tecentriq, Venclextra, Vidaza, Reblozyl, Imetelstat, CAR-T for myeloma and the new bispecific epcoritamab (Epkinly). I could include other drugs we have helped develop, but the point is, this is very important work and very gratifying to patients, doctors and staff who are so much a part of this process.”
AON Research Committee
Another physician focusing on elevating clinical trials and addressing the present healthcare disparities is Dr. Ruemu E. Birhiray from Hematology Oncology of Indiana. With assistance from his daughter, Maya, they have created the D.R.I.V.E. initiative aimed at racial diversity in clinical trials.⁵ The D.R.I.V.E. acronym represents the following steps:
D: Diversity officer for clinical research studies.
R: Ranking for clinical studies.
I: Individual diversity, equity, inclusion and access plan.
V: Verification of study diversity.
E: Elevate and enhance training of minority investigators and research team members.
The future of clinical trials is bright and makes use of the advanced technology that is available today, including AI, according to Dr. Boccia. “Artificial intelligence is findings its way into clinical trial management, from patient identification and recruitment efforts to managing some of the tedious responsibilities of a clinical trial program such as data collection and reporting back to sponsors of data, which saves countless hours of CRC time.”
To learn about AON’s active clinical trials, visit www.aoncology.com/clinical-trials/.
AON Research Sites
Cancer & Blood Specialists of Arizona *
Desert Hematology Oncology *
Genesis Cancer & Blood Institute
Hematology Oncology Clinic
Hope Cancer Care of Nevada
Messino Cancer Centers
Michigan Cancer Specialists
Oncology Hematology Associates
Summit Cancer Centers
The Center for Cancer & Blood Disorders
Vista Oncology
Zangmeister Cancer Center
* Coming in 2023
References:
1. Gehan, E. A., & Schneiderman, M. A. (1990). Historical and methodological developments in clinical trials at the national cancer institute. Statistics in Medicine, 9(8), 871–880. https://doi.org/10.1002/sim.4780090803.
2. NIH U.S. National Library of Medicine (2023, June 2). Trends, Charts, and Maps. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/resources/trends.
3. Institute of Medicine (US) Forum on Drug Discovery, Development, and Translation (2010). Transforming Clinical Research in the United States: Challenges and Opportunities: Workshop Summary. NIH National Library of Medicine, National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK50895/.
4. (n.d.). Cutting-Edge Clinical Trials. American Oncology Network. https://www.aoncology.com/clinical-trials/.
5. Anderson, C. (2022, August 31). “DRIVE” Strategy Provides Framework to Promote Racial Representation Cancer Clinical Research. Inside Precision Medicine. https://www.insideprecisionmedicine.com/topics/oncology/drive-strategy-provides-framework-to-promote-racial-representation-cancer-clinical-research/
