Improving recruitment to clinical trials for regional and rural cancer patients through a regionally based clinical trials network

Muthusamy, Arun; Long, D. Yeo Chen; Underhill, Craig

doi:10.5694/mja2.51078

Cited by 8 publications

(13 citation statements)

References 8 publications

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“…The lower survival for all Australian cancer patients living in more remote areas, irrespective of whether they were First Nations peoples or not, is consistent with the vast distances and small populations in these communities, causing difficulties in ensuring sufficient coverage of health services [25]. This has been associated with later diagnosis of cancer [26], less treatment [27] and/or lack of access to clinical trials [28]. Digital interventions such as telemedicine are increasingly being considered as an adjunct service [29,30], and have already demonstrated benefit in rural Aboriginal health-care settings [31].…”

Section: Discussionmentioning

confidence: 94%

Cancer survival differentials for Aboriginal and Torres Strait Islander peoples in Queensland: the impact of remoteness

Cramb

Whop

Garvey

et al. 2022

Cancer Causes Control

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Purpose In Australia, Aboriginal and Torres Strait Islander peoples (First Nations population) often have low overall cancer survival, as do all residents of geographically remote areas. This study aimed to quantify the survival disparity between First Nations and other Queenslanders for 12 common cancer types by remoteness areas. Methods For all Queensland residents aged 20–89 years diagnosed with a primary invasive cancer during 1997–2016, we ran flexible parametric survival models incorporating age, First Nations status, sex, diagnosis time period, area-level socioeconomic status, remoteness categories and where appropriate, broad cancer type. Three survival measures were predicted: cause-specific survival, survival differences and the comparative survival ratio, each standardised to First Nations peoples’ covariate distributions. Results The standardised five-year cause-specific cancer survival was 60% for urban First Nations and 65% for other Queenslanders, while remote residents were 54% (First Nations) and 58% (other). The absolute survival differential between First Nations and other Queenslanders was often similar, regardless of remoteness of residence. The greatest absolute difference in five-year standardised cancer survival was for head and neck cancers, followed by cervical cancer. The five-year comparative survival ratio (First Nations: other Queenslanders) for urban cancer patients was 0.91 (95% CI 0.90–0.93), similar to outer regional, inner regional and remote areas. The greatest comparative survival differential was for oesophageal cancer. Conclusion First Nations’ survival inequalities are largely independent of geographical remoteness. It remains a priority to determine the contribution of other potential factors such as the availability of culturally acceptable diagnostic, management and/or support services.

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Section: Discussionmentioning

confidence: 94%

Cancer survival differentials for Aboriginal and Torres Strait Islander peoples in Queensland: the impact of remoteness

Cramb

Whop

Garvey

et al. 2022

Cancer Causes Control

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“…Using telemedicine in a clinical trial is feasible in Australia by using the Australasian Teletrial Model while ensuring the reach of cancer clinical trials 11 . Much has been learned, evidence has been collated, and resources have been developed on how to successfully apply the Australasian Teletrial Model within health services and health systems 2–4,11,12 . This Model has been comprehensively assessed and reports in the literature acknowledge that the Teletrial Model is feasible and acceptable, enabling the overcoming geographical disparities 11–15 .…”

Section: Discussionmentioning

confidence: 99%

“…11 Much has been learned, evidence has been collated, and resources have been developed on how to successfully apply the Australasian Teletrial Model within health services and health systems. [2][3][4]11,12 This Model has been comprehensively assessed and reports in the literature acknowledge that the Teletrial Model is feasible and acceptable, enabling the overcoming geographical disparities. [11][12][13][14][15] The Model aims to be "patient focused" to improve patient equity and access to clinical trial treatment pathways.…”

Section: Key Concepts What Worked? Lessons Learned? Recommendationsmentioning

confidence: 99%

“…[2][3][4]11,12 This Model has been comprehensively assessed and reports in the literature acknowledge that the Teletrial Model is feasible and acceptable, enabling the overcoming geographical disparities. [11][12][13][14][15] The Model aims to be "patient focused" to improve patient equity and access to clinical trial treatment pathways. 3 COVID-19 has been a catalyst for engagement, 16 with international interest in the work increasing.…”

Section: Key Concepts What Worked? Lessons Learned? Recommendationsmentioning

confidence: 99%

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Teletrials, the new norm? Expert recommendations for teletrials into the future: Findings from the Clinical Oncology Society of Australia Clinical Trial Research Professionals Group Workshop

Roberts

Cubitt

Lindsay

et al. 2022

Asia-Pac J Clncl Oncology

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Introduction The Australasian Teletrial Model was piloted in co‐funded sites across Australia. The purpose was to extend the reach of clinical trials using telemedicine to improve equity and access to this treatment pathway for oncology patients. Experts across Australia gathered to share the learnings of implementation so that future directions can be effective and sustainable. Methods The 1‐day workshop was attended in person and virtually. Attendees were invited to analyze and disseminate the results. Recordings from the presentations were coded independently by three researchers and synthesized. The results were sent to the authorship team for further review to build consensus on the findings in three drafts. Results Four key themes were identified: “Being on the Same Page,” “Building Foundations,” “Key Roles in Teletrials,” and “Incentives.” Although there were many successes that were accelerated by the COVID‐19 pandemic, there is work still to be done. Conclusion The Australasian Teletrial Model has been identified as acceptable and feasible. Future directions need to continue to work on streamlining regulatory processes, implementation and monitoring, and build knowledge to further build networks across Australia.

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“…This likely reflects that people residing in regional centres tend to be closer to metropolitan Victoria, where more CCTs are available, as well as the fact that there are more CCT units in Victoria's regional centres than in more rural and remote parts of Victoria. 30 The lack of clinical trial opportunities rurally requires most clinical trial participants to travel to a metropolitan trial unit. In our study, 368 rural residents travelled to a metropolitan trial unit.…”

Section: Travelmentioning

confidence: 99%

Differences in cancer clinical trial activity and trial characteristics at metropolitan and rural trial sites in Victoria, Australia

McPhee,

Leach,

Nightingale

et al. 2024

Australian J Rural Health

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ObjectiveCancer clinical trials (CCTs) provide access to emerging therapies and extra clinical care. We aimed to describe the volume and characteristics of CCTs available across Victoria, Australia, and identify factors associated with rural trial location.MethodsQuantitative analysis of secondary data from Cancer Council Victoria's Clinical Trials Management Scheme dataset.DesignA cross‐sectional study design was used.SettingCCTs were available Victoria‐wide in 2018.ParticipantsThere were 1669 CCTs and 5909 CCT participants.Main Outcome MeasuresRural CCT location was assessed as a binary variable with categories of ‘yes’ (modified Monash [MM] categories 2–7) and ‘no’ (MM category 1). MM categories were determined from postcodes. The highest (‘least rural’) MM category was used for postcodes with multiple MM categories.ResultsOf 1669 CCTs, 168 (10.1%) were conducted in rural areas. Of 5909 CCT participants, 315 (5.3%) participated in rural CCTs. There were 526 CCTs (31.5%) with 1907 (32.3%) newly enrolled participants. Of 1892 newly enrolled participants with postcode data, 488 (25.8%) were rural residents. Of them, 368 (75.4%) participated in metropolitan CCTs. In a multivariable logistic regression analysis for all 1669 CCTs, odds of a rural rather than metropolitan CCT location were significantly (p‐value <0.05) lower for early‐phase than late‐phase trials and non‐solid than solid tumour trials but significantly (p‐value <0.05) higher for non‐industry than industry‐sponsored trials.ConclusionsIn Victoria, 10% of CCTs are at rural sites. Most rural‐residing CCT participants travel to metropolitan sites, where there are more late‐phase, non‐solid‐tumour and industry‐sponsored trials. Approaches to increase the volume and variety of rural CCTs should be considered.

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Improving recruitment to clinical trials for regional and rural cancer patients through a regionally based clinical trials network

Cited by 8 publications

References 8 publications

Cancer survival differentials for Aboriginal and Torres Strait Islander peoples in Queensland: the impact of remoteness

Cancer survival differentials for Aboriginal and Torres Strait Islander peoples in Queensland: the impact of remoteness

Teletrials, the new norm? Expert recommendations for teletrials into the future: Findings from the Clinical Oncology Society of Australia Clinical Trial Research Professionals Group Workshop

Differences in cancer clinical trial activity and trial characteristics at metropolitan and rural trial sites in Victoria, Australia

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