Building a community-academic partnership to improve clinical trial access in southern Alabama.

Abstract

e13524 Background: In our efforts to identify and remove barriers to clinical trial enrollment in Alabama, we performed an updated analysis of our community-academic partnership’s established molecular tumor board and its success in referring patients to clinical trials. This study analyzes our current performance and compares it to our previous study which aimed to identify screening and enrollment barriers. Methods: Between January 2024 and December 2024, a collaborative committee of physicians, trial coordinators, and navigators from Infirmary Cancer Care (ICC) (Mobile, AL) (community site) and the O'Neal Comprehensive Cancer Center at UAB (academic site) reviewed 290 patients from ICC, all of whom had Next Generation Sequencing data and potential eligibility for a clinical trial at UAB. Patients were identified for either upfront or second line trials at UAB and their eligibility and enrollment or reason for non-enrollment recorded. We retrospectively analyzed this data with descriptive statistics. Results: This study encompassed a cohort of 290 patients compared to 115 in the prior study, an almost 15% increase when accounting for the time period. The median age of participants was 67 years (range: 22-87), with males comprising 57% and females 43% of the group, and the majority being Caucasian (69%). The predominant tumor types included non-small cell lung cancer (31.3%), pancreatic cancer (11.1%), colorectal cancers (10%), breast cancer (7%), and biliary tract cancers (7%). Frequent genomic alterations were observed in TP53 (46.2%), KRAS (29%), PTEN (17.1%), CDKN2 (13.4%), PIK3CA (8.9%), and ARIDIA (7.4%). Among those prescreened, 33.4% lacked available trials, and 3 patients (1%) failed to return for follow-up visits. 30.3% of the patients were deemed ineligible for trials due to factors such as advanced cancer staging, presence of second primary malignancies, brain metastasis, dialysis status, poor performance scores, or social issues. 102 patients (35.1%) had a clinical trial option at UAB, a proportional decrease from the previous study. Of these, 15 (14.7%) were unable to participate due to patient preference (10 patients) and technical factors (5 patients, such as the need for repeat biopsy), a proportional decrease from over 50% in the prior study. From the 87 patients who remained potentially eligible, 54 (62.06%) were referred to UAB, of whom 23 (42.5%) were evaluated and 9 (16.6%) were enrolled in a disease-specific study. Accounting for differences in the time period examined, these numbers represent a 50% increase in enrollment from the previous study. Conclusions: Regularly recurring, collaborative clinical data review meetings between community and academic partners, reliably and efficiently offer clinical trial participation to patients who otherwise would have no or limited access. To further increase access, we plan to focus on removing specific barriers identified by these studies.