Role expansion of advanced practice providers over 5 years at Hawai'i's NCI Community Oncology Research Program.

Abstract

9041 Background: Advanced Practice Providers (APPs), including Nurse Practitioners and Physician Associates, are key members of the oncology team but historically have not been utilized to their full potential in cancer clinical trials. In alignment with NCI policy and guideline changes in 2020 & 2021, the University of Hawaiʻi Cancer Center & Hawaii NCI Community Oncology Research Program (NCORP) began formally engaging their APPs to maximize clinical trial efforts. The objectives of the current project were to measure the impact of the APP role expansion and identify factors contributing to enhancement of APP role in cancer clinical trials. Methods: Data were gathered from the clinical trial management system analyzing APP contributions annually from 2021-2025, including the number of unique APP accruals (enrolling or referring), APPs serving as enrolling/referring investigators, APPs serving as site principal investigator, APPs reviewing trials for feasibility and scientific merit, and trials led by APPs. Informal interviews were conducted to identify the means of APP engagement. Results: From 2021 through 2025 the annual number of patients enrolled or referred to trials by APPs increased from 28 to 103, APPs who accrued patients to trials increased from 4 to 13, APPs serving as site PIs increased from 1 to 6, APPs reviewing trials for feasibility and scientific merit increased from 4 to 6, and trials being led by APPs increased from 13 to 30. In 2025, among trials that allowed APP accrual (symptom management and cancer care delivery), APPs accounted for 51% of this site's total accrual. Factors contributing to APP role in cancer clinical trials were identified as APP leadership and engagement, formal and informal mentorship, and APP educational opportunities. Conclusions: APPs can significantly contribute to cancer clinical trials in terms of accrual and leadership as evidenced by these results. This project illuminates potential avenues for expanding APP roles in clinical research. This group will engage APPs on neighbor islands and Guam with an ultimate goal of increasing clinical trial access for underserved populations who reside on these islands.