Tag Archive for: National Cancer Institute

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

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Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans from Patient Empowerment Network on Vimeo.

How can veterans with lung cancer access support services for clinical trials? Expert Dr. Michael Kelley from Duke University School of Medicine discusses clinical trials at VA locations, support services to help access clinical trials, and proactive patient advice for transportation costs to clinical trials. 

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“So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed?”

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Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

Transcript:

Lisa Hatfield:

So if a patient finds a clinical trial that’s outside of the VA, will the VA help coordinate that being a part of that clinical trial if it’s outside of the VA? And the other question I would have about that, are clinical trials done at all of the VA facilities or if a person sees one that’s done, maybe they go to a smaller facility, they have to go somewhere else, can they go to that larger facility for the clinical trial?

Dr. Michael Kelley:

Yeah, great questions. So several different answers to that. So there are…some VAs do clinical trials and some don’t. And any clinical trial is not open at every VA. So if it’s open at some VAs, it may not be open at other VAs. So if the veteran finds a clinical trial at another VA and they’re willing to travel to that other location, there are generally no barriers to doing that and to enrolling in that clinical trial at the other VA.

But let me start with the first part of your question is, well, how do I find a clinical trial? So this is, I think, a barrier that we’ve all realized, and we’ve set up a service that is called the Clinical Trial Navigation Service. So a provider can ask this service to talk with the veteran and to help find a clinical trial that might be appropriate for them and then to report that back to the provider. So they can talk about what geographic area would be appropriate for the veteran and then other characteristics of the veteran and their medical care that would help inform if there’s a clinical trial available.

In the VA or outside the VA, we’ve initially partnered a lot with the National Cancer Institute at the NIH Clinical Center in Bethesda, Maryland where they will actually provide transportation for people to enroll in clinical trials at that center.

So that’s one of the areas we’ve been working with and then a few other organizations or systems. So that is one thing is you have to find the clinical trial. And the other part of your question was, you know, will VA help the patient get there? Okay. So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed.

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Advice for Accessing Advanced Non-Melanoma Skin Cancer Clinical Trials

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Advice for Accessing Advanced Non-Melanoma Skin Cancer Clinical Trials from Patient Empowerment Network on Vimeo.

Participating in advanced non-melanoma skin cancer clinical trials may feel overwhelming for some patients. Dr. Soo Park discusses how clinical trials fit into patient care and shares advice for overcoming obstacles to accessing cutting edge therapies.

Dr. Soo Park is a Medical Oncologist at Moores Cancer Center at UC San Diego Health. Learn more about Dr. Park.

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Non-Melanoma Skin Cancer Staging | What Patients Should Know

Non-Melanoma Skin Cancer Staging | What Patients Should Know

 Advanced Non-Melanoma Skin Cancer | Establishing a Treatment Plan

Advanced Non-Melanoma Skin Cancer | Establishing a Treatment Plan

 An Expert’s Perspective on Advanced Non-Melanoma Skin Cancer Research

An Expert’s Perspective on Advanced Non-Melanoma Skin Cancer Research

Transcript:

Katherine:

Beyond what has been approved to treat advanced non-melanoma skin cancer, where do clinical trials fit in?  

Dr. Park:

Clinical trials are great, because they’re the reason why we have the drugs that we have today that are working so effectively. And so, I’m really fortunate to be at a center where we offer clinical trials for patients.  

Clinical trials always fit in at any point in the journey, as long as they fit your disease. So, most of the clinical trials we have are for patients that have advanced disease, not for early stage, because the early stage patients don’t really need it; because with just simple surgery, they tend to do really well, and their cancer doesn’t really ever come back and cause issues.  

But clinical trials are really important, because they’re the only way we can study a promising treatment option; see how well it works, and if it works really well, then move it further on to hopefully help a lot of other people. And that’s why we have immunotherapy today – is through clinical trials; and immunotherapy is used for lots of cancers.  

Katherine:

Are there barriers to accessing trials? And if so, do you have any recommendations on how to tackle them?  

Dr. Park:

Yeah, there are barriers to trials, and I think the thing that the cancer community is really trying to work on is barriers to accessing trials if you’re from an underrepresented population in medicine. So, based on your socioeconomic status, meaning how much money do you make or what your education level is, what race are you, what ethnicity, what is your background; because we know that there’s a disparity for those individuals. And so, I think really asking your doctor, staying curious; asking them, “Could a clinical trial help me?” 

Even if you have no idea of really what trials there are, or what they really mean, you can just throw that word out; and that then, the doctor knows that you’re potentially interested, and they can actually give you the information and help you learn more about it, even if you don’t know much about it; because I think it’s still quite a black box, and we’re trying to overcome this barrier, but it’s difficult.  

Katherine:

And what about researching clinical trials online? What sites would you recommend?  

Dr. Park:

So, I have to admit that there are multiple sites, but sometimes they are not very patient-friendly. Even whenever I look at them, they are not very friendly. I think the largest repository of clinical trials is the NCI database. It’s just where every clinical trial that’s open has to be registered, and it’s run by the federal government, I believe. And because it’s not super regulated, it’s just the person working on the trial entering information, and they’re typically of a medical background, sometimes the information is not very easy to digest or understand.  

So, I think really just letting your medical team know that you might be interested in a trial, then they can help you find the right trial for you. And if they don’t have one, they can tell you other areas or other centers that might have one. You are more than welcome to go search in Google and all that, but it can be really hard, and then I don’t want that to make the patient feel that this is not for them.  

What AML Clinical Trial Inequities Do Minority and Ethnic Groups Face?

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What AML Clinical Trial Inequities Do Minority and Ethnic Groups Face? from Patient Empowerment Network on Vimeo.

Do minority and ethnic groups face acute myeloid leukemia (AML) clinical trial inequities? Expert Dr. Andrew Hantel from Dana-Farber Cancer Institute and Harvard Medical School discusses research study results of NCI-designated cancer centers of AML versus other cancers and proactive patient advice for clinical trial access.

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“…patients to ask about where the nearest sites of care are for them that have clinical trials on at least historically, and then reaching out to those sites to ask, ‘Can I have a consultation?” Am I somebody who might be eligible for any of the clinical trials that you have?’”

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Why Is Post-Access Enrollment Vital in AML Clinical Trial Participation?

 Underrepresented AML Clinical Trial Groups | What Solutions Are Underway

Underrepresented AML Clinical Trial Groups | What Solutions Are Underway

Transcript: 

Lisa Hatfield:

Dr. Hantel, what primary findings are in your study regarding inequities and clinical trial participation among minoritized race and ethnic groups with cancer at the comprehensive cancer centers?

Dr. Andrew Hantel:

So we performed a couple of different studies on this, I think together, they’ve collectively found that there are significant disparities in clinical trial participation among minoritized racial and ethnic groups at comprehensive cancer centers. And just to take a step back and say, what are comprehensive cancer centers? They’re basically a designated center, and the designation is provided by the National Cancer Institute (NCI), and that basically says that this place is of such and such a level of quality in terms of their delivery of cancer care and their research that they perform, and so these are generally larger academic centers that have a lot of clinical trials, have a lot of experts across different cancer types, including AML. And those are the ones that we are wondering if people had equal or equitable access to, in other cancers compared to AML.

A lot of the disparities in clinical trial participation is really because these different minoritized groups have less access to these comprehensive cancer centers, so they could really never be considered for trials, because they’re just not seen at places where the trials are taking place. This is the case for a lot of common solid tumors, such as breast and colon cancer, where very, very large proportions of patients are seen in the community.

And this means that in leukemia, however, we found that participation disparities were not only due to access, but because the leukemia is less common because a lot of docs actually almost preemptively refer some of their patients to get seen, some of the disparity is kind of shifted, and it ends up becoming not as much an issue just of access but also of getting into the trial after they’re seen at the center.

And this can be because of a variety of things, there are reasons that we can go into in a second, but we kind of also want to make the statement in the context of it not being a one-size-fits-all answer. There are some cases where comprehensive cancer centers actually both allow great access and allow equitable enrollment on their trials, and there are other comprehensive cancer centers that have had…and continued to have issues with this. 

So I also just want to make sure to make that distinction. But after somebody gets down to a center, you have the process of, is there a trial at the center that’s actually right for your specific type of leukemia and the stage of the disease, and if you’re up front or relapsed or all of these other nuances, and then you have the questions of, are you eligible, are you offered that trial, and then are you interested in partaking in that trial, and is it feasible for you to participate?

So there are all these other steps after that point of access, and in general, what we saw was that it was kind of these later steps that were as much more of an issue for equitable enrollment for leukemia as that first step of access. And so it’s slightly different from what we’ve seen in other cancers, and so the answers and the solutions for that are going to be different.

So my activation tip for this question would be for patients to ask about where the nearest sites of care are for them that have clinical trials on at least historically, and then reaching out to those sites to ask, “Can I have a consultation?” Am I somebody who might be eligible for any of the clinical trials that you have?” That might be something where it does take you to that site to actually get evaluated and see if there is anything available, but that would be the first step.

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What Are Common Barriers to Clinical Trials Access?

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What Are Common Barriers to Clinical Trial Access? from Patient Empowerment Network on Vimeo.

Clinical trials are key to the approval of new breast cancer treatments. But what factors could prevent some patients from participating? Expert Dr. Jame Abraham reviews common barriers and emphasizes the commitment of the oncology community to improving trial access.

Dr. Jame Abraham is the chairman of the Department of Hematology & Medical Oncology at Cleveland Clinic and professor of medicine at Cleveland Clinic Lerner College of Medicine. Learn more about Dr. Abraham.

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When Should Breast Cancer Patients Consider a Clinical Trial?

Transcript:

Katherine:

Dr. Abraham, what are barriers to accessing clinical trials?  

Dr. Abraham:

That’s a really good question. I think we need to continue to work on breaking down the barriers. And the most common barrier is, wherever she, or he, are going for the treatment, they don’t have access to a client. There’s no trial available. The second, let’s just say, if I can say, the lack of awareness from the provider, or the patient’s side, about the importance of trial. And then, third, some trials can be complicated. So, it requires multiple appointments, or multiple trips to the doctor’s office, or the hospital, or the cancer center. So, that may not be feasible for everybody. Somebody has limited access, limited support, it can be tough. 

And then, let’s just say, that people have comorbid conditions, if I can say. Other conditions, heart disease, or other things, or they’re not able to be more active, and some of those things, can make that person ineligible for a trial. 

So, there are a number of things, potentially, can be barriers, but I think, as an oncology community, as cancer centers, we need to continue to work on optimizing, or breaking down, these barriers.  

As a nation, we have a huge – we have a lot of work in addressing the disparities in cancer care.

As you know, where you’re born, and it can be innercity, Cleveland, innercity, Detroit, or it can be in the Appalachia, where you’re born, and what’s your access to healthcare, that plays a major role. 

And, of course, your race, and your education, I know that plays a major role in access to healthcare, and then, able to continue with treatment, and that plays a similar role in clinical trials, too. So, the number of patients entering clinical trials from different race, especially African American patients, are less, compared to the other patient population. So, there is a lot of work, need to be done, in addressing the disparities in cancer care, in general, and especially clinical trials. 

Katherine:

And I imagine that’s a focus for many of the people working on trials?  

Dr. Abraham:

It’s a focus for National Cancer Institute, it’s a focus for all the cancer centers, absolutely.