New Community Partnership Increases Clinical Trials Enrollment
If Memory Serves...
An important part of the National Cancer Institute Act was the authorization to design a program that would increase physicians' abilities to diagnose and treat cancer. It provided "traineeships" to young doctors who had graduated from medical school and completed 1-year internships, and who pledged to devote themselves to the specialty of diagnosing and treating cancer. (Read more)
For more information about the birth of NCI, go to http://www.cancer.gov/
In 2006, NCI's Center for Cancer Research (CCR) was approached by a local clinical practice to increase communication about early-phase clinical trials for which their patients might be eligible at the NIH Clinical Center. The Clinical Center only admits and treats patients enrolled in clinical trials, distinguishing it from other hospitals in the United States. While this specialization allows an absolute dedication to clinical research within the Center, it lacks a built-in base of patients receiving standard treatments who might be interested in participating in clinical trials.
Physicians at Associates in Oncology/Hematology (AOH), a private practice in Rockville, MD, were seeking to expand the clinical trial options available to their patients. "We've been committed to clinical trials in our practice, and we participate in cooperative group trials and pharmaceutical trials," explained Dr. John Wallmark, one of AOH's seven oncologists, "but we felt that there was a need to continue to expand the options for our patients. As our patients got further along in their illnesses, a lot of times innovative clinical trials weren't available, and clinical trials in oncology are extremely important to incorporate into your treatment options."
Three AOH physicians had received training at NCI. This experience and the group's close proximity to the NIH campus led AOH to propose a pilot partnership: CCR would identify an onsite research nurse with experience in early-phase trials to screen patients in the community receiving primary cancer care at AOH, and AOH would refer eligible patients to CCR trials by the end of 12 months.
By May 2007, the pilot project had met its accrual goal, almost half a year ahead of schedule. Out of 109 patients referred to CCR by AOH, 20 have started treatment on clinical trials, with 26 additional enrollments pending. Importantly, patients enrolled through the partnership retain the patient/caregiver bond with their primary oncologist, and NCI physicians supply the AOH oncologist with regular updates on the enrolled patient.
The success of the pilot program has led to plans for expansion. The partners hope to begin several early-phase CCR trials based at AOH and the Clinical Center. "Patients want to remain in the community, and doctors like them to remain in the community," said Dr. Wallmark. "A big barrier to enrollment in these studies is the fact that most patients don't want to leave the setting in which they are comfortable - it's very daunting."
"I think this partnership is exciting," said Caryn Steakley, deputy clinical director of CCR. "It's something new and different for CCR to be doing, and I think it has a lot of promise for other groups or institutions interested in this kind of partnership."