Impact of Electronically Accessible Pathways on Clinical Trial Enrollment at a Large Multisite Cancer Center

A presentation at the ASCO Annual Meeting explored the role that the clinical pathways program at the Levine Cancer Institute (Charlotte, NC) plays in clinical trial enrollment.

Researchers from Levine Cancer Institute said that clinical pathways streamline evidence-based treatment decisions and provide consistent, high-quality, value-based care. A high-quality clinical pathway should enhance screening and access to clinical trials. 

Levine Cancer Institute/Atrium Health utilizes Electronically Accessible Pathways (EAPathways) to allow providers to select treatment regimens vetted by section experts, inquire about clinical trials, and refer to relevant programs (eg, palliative medicine) or testing (eg, genomics) at its main cancer center and 22 regional sites. They currently have over 400 clinical trials and aim to provide access regardless of where a patient lives or receives treatment.

To better understand the impact their pathways have in clinical trial enrollment, authors performed a retrospective review to compare clinical trial inquiries through EAPathways and clinical trial enrollment using Oncore between January 1, 2017, and July 31, 2018. The primary outcome was the success rate reported as the total number of inquiries that resulted in clinical trial enrollment. The number of and reason for opting out of treatments or trials was also analyzed.

A total of 29.1% (740/2539) of clinical trial inquiries through EAPathways resulted in clinical trial enrollment. Success rates for the following settings were reported: 39.5% (223/564) in hematology, 26.2% (517/1975) in solid tumor oncology, 27.0% (594/2203) in treatment trials, and 43.5% (146/336) in nontreatment clinical trials. Sixty-three percent of enrollments were at the main cancer center compared to regional sites. A total of 39.7% (3356/8453) of patients were enrolled into an opt-out pathway due to reasons such as performance status, organ dysfunction, or hospice.

Authors concluded that clinical pathways are helpful in facilitating clinical trial enrollment in multiple settings. They plan to use these baseline metrics to assess process improvement needs to increase clinical trial enrollment success rates and address reasons for opt-out.—Amanda Del Signore