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. 2020;43(5):196-203.
doi: 10.1159/000506840. Epub 2020 Mar 27.

A Retrospective Analysis of Clinical Trial Accrual of Patients Presented in a Multidisciplinary Tumor Board at a Tertiary Health Care Center and Associated Barriers

Erin M Mobley  1 , Umang Swami  2 , Sarah Mott  3 , Agnes Ounda  4 , Mohammed Milhem  5 , Varun Monga  6
Affiliations

A Retrospective Analysis of Clinical Trial Accrual of Patients Presented in a Multidisciplinary Tumor Board at a Tertiary Health Care Center and Associated Barriers

Erin M Mobley et al. Oncol Res Treat. 2020.

Abstract

Introduction: Cancer clinical trial accruals have been historically low and are affected by several factors. Multidisciplinary Tumor Board Meetings (MTBM) are conducted regularly and immensely help to devise a comprehensive care plan including discussions about clinical trial availability and eligibility.

Objectives: To evaluate whether patient discussion at MTBM was associated with a higher consent rate for clinical trials at a single tertiary care center.

Methods: Institutional electronic medical records (EMR) and clinical trials management system (OnCore) were queried to identify all new patient visits in oncology clinics, consents to clinical trials, and MTBM notes between January 1, 2011 and December 31, 2015. The association between MTBM discussion and subsequent clinical trial enrollment within 16 weeks of the new patient visit was evaluated using a χ2 test.

Results: Between January 1, 2011 and December 31, 2015, 11,794 new patients were seen in oncology clinics, and 2,225 patients (18.9%) were discussed at MTBMs. MTBM discussion conferred a higher rate of subsequent clinical trial consent within 16 weeks following the patient's first consultation in an oncology clinic: 4.1% for those who were discussed at a MTBM compared to 2.8% for those not discussed (p < 0.01).

Conclusions: This study provides evidence that MTBMs may be effective in identifying patients eligible for available clinical trials by reviewing eligibility criteria during MTBM discussions. We recommend discussion of all new patients in MTBM to improve the quality of care provided to those with cancer and enhanced clinical trial accrual.

Keywords: Barriers; Clinical trial; Multidisciplinary tumor board; Tumor board.

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Conflict of interest statement

Disclosures:

Erin Mobley, Sarah Mott, and Umang Swami have no conflicts of interest to disclose. Mohammed Milhem has the following disclosures: Research funding from Amgen,Novartis,Merck,Pfizer, ER Squibb & Sons, Prometheus. Honoraria from Blueprint Medicine, Immunocore, Amgen, Trieza. Consulting or advisory role Blueprint Medicine, Amgen, Immunocore, Trieza. Varun Monga has the following disclosures: Research funding and travel expenses from Deciphera. Research funding from Orbus Therapeutics, Immuno cellular. Consulting or advisory role from Forma Therapeutics.

Figures

Figure 1.
Figure 1.
Flowchart of tumor board discussion and subsequent clinical trial consent for patients seen at the University of Iowa Health Care, 2011–2015
Figure 2.
Figure 2.. Patient investigational study status following consent by disease site (N=357)
aGU: Genitourinary; Gyn: Gynecologic; GI: Gastrointestinal; CNS: Central Nervous System
Figure 3.
Figure 3.. Reason for non-enrollment in a clinical trial after consent (N=76)
aPatient preference included: travel, sought treatment elsewhere, concerns of toxicity, unsure insurance would cover treatment, and decided not to pursue any treatment. bOther included: unknown and failed test dose of investigational drug.
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