Expectations of cancer patients about clinical trials in multidisciplinary clinics

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17563-e17563
Author(s):  
G. H. Kloecker ◽  
M. Janjua ◽  
J. Day ◽  
D. Lee
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Effective Interaction ◽  
Management Plan ◽  
Clinic Visit ◽  
Cancer Center ◽  
Academic Settings ◽  
The Difference ◽  
Multidisciplinary Conference ◽  
Multidisciplinary Clinics

e17563 Background: Progress in cancer treatment is very much dependent on the effective interaction of several specialties. To facilitate the process, more and more multidisciplinary clinics have been created over the last decade, especially in academic settings. This approach has been more established in the academic setting to help facilitate better patient accrual to clinical trials. Although there are studies confirming the effectiveness of this approach in fulfilling practice guidelines, there is however no study of patients’ expectations at a multidisciplinary clinic, especially in regard to the patients’ attitude towards clinical trials. This study examines patients’ preferences for services offered in an academic Methods: Surveys were handed to patients at the time of the first clinic visit and at time of progressive disease. The surveys were designed as a self directed questionnaire with the following questions that were rated on an ordinate scale from not at all important (score 1) to extremely important value (score 7): to see all doctors the same day; to be treated at a university-based cancer center; to have everything completely explained; to have the first appointment within 10 days; to know your cases will be discussed at conference; to have help with transportation and medical costs; and to participate in clinical trials. Results: 94 patients were surveyed at the GI and Thoracic Multimodality Clinic. Among patients the highest preference was “to have every thing explained,” score 6.7 (6.5–7.0, CI), immediately followed by the discussion at the multidisciplinary conference, score 6.6 (6.5–6.8, CI). Clinical trials ranked lowest, score 4.8 (4.4–5.2,CI). The difference was statistically significant, p = 0.012. There was no difference between GI and Thoracic Multimodality Clinic patients. Patients with progressive cancers showed a slightly higher interest in clinical trials, but still ranking trials below most other services. Conclusions: Patients value complete explanations of the disease and management plan far more than they value clinical trials. Considering that nationwide less than 5% of cancer patients are enrolled in clinical studies, it is important for physicians to explain the merit of clinical trials to patients and public. No significant financial relationships to disclose.

Improving hematology/oncology clinical research recruitment via universal prescreening: The VA Connecticut (VACT) Cancer Center experience.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 79-79
Author(s):  
Jenny Jing Xiang ◽  
Alicia Roy ◽  
Christine Summers ◽  
Monica Delvy ◽  
Jessica Lee O'Donovan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Clinical Research ◽  
Cancer Patients ◽  
Cancer Center ◽  
Cancer Type ◽  
Eligibility Criteria ◽  
Research Recruitment ◽  
Lung Cancer Patients ◽  
Study Enrollment

79 Background: Patient-trial matching is a critical step in clinical research recruitment that requires extensive review of clinical data and trial requirements. Prescreening, defined as identifying potentially eligible patients using select eligibility criteria, may streamline the process and increase study enrollment. We describe the real-world experience of implementing a standardized, universal clinical research prescreening protocol within a VA cancer center and its impact on research enrollment. Methods: An IRB approved prescreening protocol was implemented at the VACT Cancer Center in March 2017. All patients with a suspected or confirmed diagnosis of cancer are identified through tumor boards, oncology consults, and clinic lists. Research coordinators perform chart review and manually enter patient demographics, cancer type and stage, and treatment history into a REDCap (Research Electronic Data Capture) database. All clinical trials and their eligibility criteria are also entered into REDCap and updated regularly. REDCap generates real time lists of potential research studies for each patient based on his/her recorded data. The primary oncologist is alerted to a patient’s potential eligibility prior to upcoming clinic visits and thus can plan to discuss clinical research enrollment as appropriate. Results: From March 2017 to December 2020, a total of 2548 unique patients were prescreened into REDCAP. The mean age was 71.5 years, 97.5% were male, and 15.5% were African American. 32.57 % patients had genitourinary cancer, 17.15% had lung cancer, and 46.15% were undergoing malignancy workup. 1412 patients were potentially eligible after prescreening and 556 patients were ultimately enrolled in studies. The number of patients enrolled on therapeutic clinical trials increased after the implementation of the prescreening protocol (35 in 2017, 64 in 2018, 78 in 2019, and 55 in 2020 despite the COVID19 pandemic). Biorepository study enrollment increased from 8 in 2019 to 15 in 2020. The prescreening protocol also enabled 200 patients to be enrolled onto a lung nodule liquid biopsy study from 2017 to 2019. Our prescreening process captured 98.57% of lung cancer patients entered into the cancer registry during the same time period. Conclusions: Universal prescreening streamlined research recruitment operations and was associated with yearly increases in clinical research enrollment at a VA cancer center. Our protocol identified most new lung cancer patients, suggesting that, at least for this malignancy, potential study patients were not missed. The protocol was integral in our program becoming the top accruing VA site for NCI’s National Clinical Trial Network (NCTN) studies since 2019.

scholarly journals The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Cancer Center ◽  
Anti Cancer ◽  
Before And After ◽  
The Difference ◽  
The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

Cancer clinical trials available in the community setting: A 5-year analysis from 1999–2004

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6056-6056
Author(s):  
J. K. Keller ◽  
J. Bowman ◽  
J. A. Lee ◽  
M. A. Mathiason ◽  
K. A. Frisby ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Community Setting ◽  
Disease Stage ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Community Based ◽  
Eligibility Criteria ◽  
Major Barrier

6056 Background: Less than 5% of newly diagnosed cancer patients are accrued into clinical trials. In the community setting, the lack of appropriate clinical trials is a major barrier. Our prospective study in 2004 determined that 58% of newly diagnosed adult cancer patients at our community-based cancer center didn’t have a clinical trial available appropriate for their disease stage. Among those with clinical trials, 23% were subsequently found to be ineligible (Go RS, et al. Cancer 2006, in press). However, the availability of clinical trials may vary from year to year. Methods: A retrospective study was conducted to determine what clinical trials were available for newly diagnosed adult cancer patients at our institution from June 1999-July 2004. The study also investigated the proportions of newly diagnosed patients who had a clinical trial available appropriate for type and stage of disease and patients accrued. Results: Over the 5-year period, 207 (82, 87, 99, 102, 117, years 1–5, respectively) trials were available. Most (50.7%) trials were for the following cancers: breast (15.5%), lung (13.5%), head and neck (7.7%), colorectal (7.2%) and lymphoma (6.8%). ECOG (53%), RTOG (26%), and CTSU (9%) provided the majority of the trials. A total of 5,776 new adult cancer patients were seen during this period. Overall, 60% of the patients had a trial available appropriate for type and stage of their cancer, but only 103 (3%) were enrolled. There was a significant upward trend in the proportions of patients with available trials over the years (60.2%, 55.9%, 59.2%, 60.7%, 63.9%, years 1–5, respectively; Mantel-Haenszel P=.008). The proportion of patients with a trial available was highest for prostate (97.3%), lung (90.9%), and breast (73.9%), and lowest for melanoma (17.1%), renal (11.6%), and bladder (7.2%). The majority of patients accrued to trials had the following cancers: breast (32%), lung (17%), lymphoma (9%), colon (7%), and prostate (5%). Conclusions: Nearly half of the newly diagnosed adult patients at our center had no trials available appropriate for type and stage of their cancers. It is likely that if strict clinical trial eligibility criteria were applied, approximately 2/3 of our patients would not be eligible for a clinical trial. No significant financial relationships to disclose.

Screening cancer patients for clinical trial eligibility: A randomized study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6529-6529
Author(s):  
J. Wright ◽  
T. Whelan ◽  
J. Julian ◽  
M. Simunovic ◽  
M. Levine
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Primary Outcome ◽  
Randomized Study ◽  
Secondary Analysis ◽  
Chi Square ◽  
Ongoing Research ◽  
Number Of Patients ◽  
The Difference

6529 Background: The overall proportion of cancer patients enrolled into clinical trials is undesirably low. Research suggests many aspects of the recruitment process can be improved. The present study was undertaken to evaluate the benefit of identifying potentially eligible (PE) clinical trial patients for physicians. Methods: Consenting physicians were randomized to 26 weeks of screening support or not, and were then crossed-over to the other strategy for a second 26-week time period. A computer program reviewed new patient consultations to identify PE clinical trial patients. Physicians receiving support were provided with written individualized details of patient eligibility for trials prior to their medical consultation. The primary outcome of interest was the difference, by physician, in the number of patients who were approached for consent to enter a clinical trial. Results: Thirty-six physicians participated in the 52-week study. 5051 consultations were screened in a blinded fashion, 2,376 when physicians had support and 2,675 when they did not. 939 of 2,376 (39.5%) consultations were identified as involving PE patients when physicians were receiving support, and 1,061 of 2,675 (39.7%) when without. The primary outcome of the study, by physician, did not demonstrate a statistically significant improvement, with 4.1 patients per physician without vs. 4.7 patients with screening support (p>0.05). Secondary analysis demonstrated that the overall proportion of patients approached with the clinical trial option increased from 149/2,675 (5.6%) to 169/2,376 (7.1%) with screening support (Chi-square, p=0.024) and that the number of patients that entered a clinical trial also increased from 60/2,675 (2.2%) to 83/2,376 (3.5%) (Chi-square, p=0.007). Conclusions: This study suggests that individualized patient screening for clinical trial eligibility may be useful to improve the numbers of patients approached to consider clinical trials. The number of new patients that entered clinical trials remained low, and ongoing research to facilitate improvements is required. No significant financial relationships to disclose.

Improving documentation of pain and constipation management within the cancer center of a large urban academic hospital.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 192-192
Author(s):  
Iloabueke Gabriel Chineke ◽  
Marjorie Adams Curry ◽  
Giselle Dutcher ◽  
Steve Power ◽  
Leon Bernal-Mizrachi
Keyword(s):  
Management Plan ◽  
Clinic Visit ◽  
Cancer Center ◽  
Quality Improvement Initiative ◽  
New Order ◽  
Nursing Assessment ◽  
Effect Analysis ◽  
Percentage Point Increase ◽  
One Year ◽  
Oncology Practice

192 Background: Pain and constipation are common among patients with cancer and remain inadequately controlled in many. Quality Oncology Practice Initiative (QOPI) assessment of pain and constipation at the Georgia Cancer Center for Excellence at Grady Health System identified documentation to be below benchmark levels. A quality improvement initiative to improve pain and constipation management was conducted. Methods: Given the low baseline documentation rates for pain (60%) and constipation (20%), we aimed for a 20-percentage point increase within one year. Based on cause and effect analysis and questionnaires to providers, our multidisciplinary team developed a new provider note template to integrate nurse’s assessment of pain and constipation into the provider’s documentation. A new order panel was developed in the electronic medical record (EPIC) to link appropriate orders with the pain and constipation plan. Results: Integrating the initial nursing assessment into the provider note template increased pain score documentation from 66.7% to 100%, P < 0.01 and pain management plan from 65.3% to 86.4%, P = 0.06. Similarly, constipation assessment documentation improved from 20.4% to 100%, P < 0.01 and a documented constipation plan improved accordingly from 11.2% to 29.1%, P < 0.01. As a result of this intervention, pain control at the 3rd clinic visit improved from 61.5% to 86.8%, P < 0.01. Emergency room visits related to pain and constipation decreased (16.2% to 14.9%, P = 0.19) and hospitalizations marginally increased (1.6% to 3.6%) during the study period. Conclusions: A standardized visit template and mandated assessment of pain and constipation exceeded the goal for improvement in documentation and positively impacted outcomes.

scholarly journals One Stop Neck Lump Clinic- A boon for quick diagnosis and early management

2020 ◽  
Author(s):  
Tarun Sood ◽  
Mrinal Supriya ◽  
Jacob Thopil ◽  
Vishak Surendra ◽  
Barun Patel
Keyword(s):  
Head And Neck ◽  
Needle Aspiration ◽  
Management Plan ◽  
Cancer Center ◽  
Care Hospital ◽  
Early Management ◽  
One Stop ◽  
Neck Lump ◽  
The Difference ◽  
The Uk

Abstract Introduction: One stop neck lump clinics (OSNLC) are gaining popularity worldwide especially in the UK hospitals following NICE recommendation. The main aim of this speciality clinic is quick diagnosis and early management while simultaneously improving patient experience. Objectives: To analyse and compare the efficacy of OSNLC and general ENT/Head and neck clinic with specifics to number of appointments required for formulating management plan and number of ‘one stop’ visits. Design: Retrospective observational study Setting: Regional Head and Neck Cancer Center (Secondary care hospital) Participants: Patients referred by General practitioner with symptoms of neck lump Main outcome measures: Patients seen in general ENT/Head and neck and OSNLC in 2 phases to understand the difference in number of appointments, one stop visits, requirement of Ultrasound and efficiency of Fine needle aspiration. Results and Conclusions: Improved efficacy of OSNLC was noted as patients seen in clinic required lesser number of appointments, reached a faster diagnosis and management plan when compared to patients seen in general ENT clinic.

scholarly journals Clinical outcomes of breast cancer patients treated in phase I clinical trials at University of Colorado Cancer Center

2020 ◽  
Vol 9 (23) ◽  
pp. 8801-8808
Author(s):  
Jennifer A. Weiss ◽  
Andrew Nicklawsky ◽  
Jodi A. Kagihara ◽  
Dexiang Gao ◽  
Christine Fisher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Phase I ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Phase I Clinical Trials ◽  
University Of Colorado

Poor access to clinical trials among community cancer patients requiring chemotherapy for recurrent or progressive disease: Limitations of current cancer cooperative groups

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6076-6076 ◽  
Author(s):  
L. A. Meyer ◽  
J. A. Lee ◽  
M. A. Mathiason ◽  
K. A. Frisby ◽  
K. C. Bruden ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Progressive Disease ◽  
Cancer Center ◽  
Cooperative Groups ◽  
Newly Diagnosed ◽  
Poor Access ◽  
Accrual Rate ◽  
Clinical Trial Accrual ◽  
A Prospective Study

6076 Background: Data on clinical trial accrual among cancer patients treated in the community are limited. In a prospective study at our community-based cancer center, we found that the accrual rate was only 4% for newly diagnosed patients and protocol limitations accounted for 68% of non-accrual (Go RS, et al. Cancer 2006). We would like to determine the availability of trials for adult cancer patients with recurrent or progressive disease treated in the community and the accrual rate. Methods: We retrospectively identified this specific group of patients who received chemotherapy at our institution between November 2004 and October 2005 and collected data on the number, types, and sources of trials that were available. Results: We identified a total of 140 patients. There was an equal number of females (52.9%) and males, with a median age of 66 years (range, 38–89) at the time of chemotherapy. Fifty trials were available, with about half for the following cancers: lung (14%), pancreatic (12%), renal (10%), head and neck (8%), prostate (6%), and breast (6%). No trials were available for bladder, colorectal, and gastroesophageal cancers. The proportions of phase I, II, and III trials were 4%, 62%, and 34%, respectively. The sources of trials were: ECOG (56%), Wisconsin Oncology Network (14%), Intergroup (12%), GOG (10%), RTOG (2%), CTSU (2%), our institution (2%), and pharmaceutical companies (2%). Only 69 (49.3%) patients had trials appropriate for their type and stage of cancers. Among those patients with available trials, 24 (34.8%) were eligible to participate and 6 were enrolled, for an overall accrual rate of 4.3%. There were no differences in age and sex among subgroups in terms of trial availability, eligibility, and accrual. Conclusions: At our institution, enrollment of cancer patients with recurrent or progressive disease in clinical trials is as low as for newly diagnosed patients. Over 80% of the patients were denied access to a trial because of protocol unavailability and ineligibility. Current cancer cooperative groups do not provide adequate trials for patients in the community. No significant financial relationships to disclose.

Radiation pneumonitis (RP) in lung cancer patients treated with chemotherapy (CT) and thoracic radiation (TR): Retrospective analyses of patients treated at a comprehensive cancer center

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19642-19642
Author(s):  
P. Vishnu ◽  
S. Srinivasan ◽  
L. Heilbrun ◽  
R. Venkataramanamoorthy ◽  
A. Wozniak ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Hospitalization Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Lung Cancer Patients ◽  
Pulmonary Disorder ◽  
Demographic Features

19642 Background: Combined CT and TR is the current standard for locally advanced non-small cell lung cancer (NSCLC) and SCLC. Severe RP, an important adverse effect of TR, is reported in clinical trials to occur in 10% of patients receiving CT and TR. The rate in routine care may be higher as patients are not selected based on lung function. We conducted a retrospective study to assess the incidence of RP in lung cancer patients treated with CT and TR. Methods: Retrospective identification of patients who underwent combined modality therapy (concurrent or sequential CT and TR) for lung cancer (NSCLC & SCLC) at our cancer center between January 2001 and December 2004. Demographic features, RP incidence and grade (RTOG criteria), hospitalization rate and overall survival (OS) were assessed. Results: 51 patients who met the selection criteria were analyzed. The demographic features were - males 61%; Caucasians - 53%; African Americans - 39%; history of pulmonary disorder - 45%; NSCLC - 82%; CT - 62% received Cisplatin/Etoposide, while 24% received Carboplatin/Paclitaxel; 92% received concurrent CT and TR. The median dose of TR was 5940 cGy. 20 patients (39%) developed RP; 13 (25%) had grade = 3 RP. Median time to development of RP was 4.4 months. Rate of RP in females and males was 50% vs. 32% (p=0.25). Rate of RP in patients with pulmonary disorder at baseline was 52% vs. 29% in others (p=0.15). 1 year hospitalization rate was 75% and 42% in RP and non-RP patients (p=0.025). For all 51 patients, the median overall survival (OS) was 16.4 months (95% CI 11.8 - 23.3). Length of OS did not differ significantly (p = 0.36) between the 20 patients who had RP vs. the 31 who had no RP (median OS: 22.2 vs. 14.5 months, respectively). Conclusions: The RP rate in these 51 lung cancer patients treated off- protocol with CT and TR is higher than that reported in clinical trials. Despite higher morbidity in patients with RP (i.e., increased hospitalization), survival duration did not differ significantly based on RP status. No significant financial relationships to disclose.

Perceptions concerning clinical trials in oncology patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16533-e16533
Author(s):  
Dana Lee ◽  
Ju-Hsien Chao ◽  
Sandy Stevens ◽  
Goetz H. Kloecker
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Treatment Option ◽  
Phase 1 ◽  
Cancer Center ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
Oncology Patients

e16533 Background: Accrual to clinical trials among adult cancer patients is persistently low. Patient preference plays an important role in enrollment. To identify the reasons why patients decline study participation, it is important, to evaluate the perceptions of newly diagnosed oncology patients about clinical trials. Methods: Patients were given a ten-question survey reflective of their attitudes regarding clinical trials as a treatment option at their initial visit. The self-directed questionnaire was scored on an ordinate scale from strongly agree (1) to strongly disagree (5). Results: Ninety-two new patients were surveyed in the cancer - specific multispecialty clinics in an academic cancer center. The patients expected information relating to eligible clinical trials and privacy protection by university sponsored studies as they strongly concurred with “I expect my doctor to inform me about clinical trials that I am eligible for” (mean score 2.15, p=0.001) followed by “all possible measures to protect my privacy are likely to be taken in a clinical trial that is sponsored by a university” (2.36, p=0.36). The strongest disagreement was “If enrolled in a clinical trial, I am comfortable being assigned by a method such as ‘flipping a coin’ or ‘throwing a dice’” (3.73, p=0.001) and “I would be willing to participate in a clinical trial as a first line treatment option” (3.50, p=0.001). Industry sponsored trials, phase 1 trials, second line treatment trials, privacy concerns and investigator initiated trials and time commitment and altruistic reasons did not significantly deviate from the mean preference (2.5) by a one sample T-test analysis. Conclusions: Patients consider the option of clinical trials as important in their treatment, and expect to be informed by their oncologist about clinical trials. Newly diagnosed cancer patients perceive randomization and first line trials negatively. Since randomized data provides new standards for care and hope for improved treatment, patients and their families must be educated about their importance.

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