Bringing Hematological Malignancy Clinical Trials to Patients: Mayo Clinic LLS Impact Experience

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.784-784
• Main Authors: Johnston, Jamie, Doane, Katie J., Waszak, Wesley, Flock, Carolyn, Khurana, Arushi, Logan, Nina, Hawley, Nanci, Al-Hattab, Eyad, Lewis, Akeem R., Ticku, Jonathan, Yosef, Amir, Ansell, Stephen M., Kumar, Shaji, Parikh, Sameer A., Shah, Mithun V, Witzig, Thomas E., Nowakowski, Grzegorz S.
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-205791

In 2023, Mayo Clinic in Rochester, MN, cared for over 20,000 patients with hematologic malignancies, roughly 42% of whom were rural. Patients residing in rural areas can face challenges in access to care, financial and time burdens due to treatment-related travel, and limited opportunities to participate in clinical trials. In 2021, The Leukemia & Lymphoma Society launched its IMPACT (Influential Medicine Providing Access to Clinical Trials) grant with Mayo Clinic being among its first recipients. The program provides funding to major cancer centers, in partnership with local community oncology centers, to help increase participation of patients traditionally underrepresented in clinical trials, including those who are rural, minority and/or economically disadvantaged. The award allowed significant changes to be made to clinical trial selection and facilitation models increasing access to trials within the rural setting and reducing the socioeconomic barriers noted above. This program included Rochester (IMPACT Hub) and Mayo Clinic Health System (MCHS) sites in Albert Lea, MN (65 miles to Hub), Eau Claire, WI (96 miles to hub), La Crosse, WI (73 miles to Hub), and Mankato, MN (84 miles to Hub). Methods: Two models were deployed; the full activation model where clinical trials were fully opened at MCHS sites, and the hybrid model where clinical trial participants are consented at the Hub and portions of participant care are conducted at MCHS sites. Initial barriers included limitations in clinical trials support staff, insufficient specimen processing equipment, medication storage and shipping limitations, MCHS catchment population unalignment with the Hub trials portfolio, and reduced bandwidth of providers due to patient care responsibilities. To address barriers to trial conduct, community center site champions were identified to streamline trial review and increase collaboration to better define site catchment areas, trial constraints, and site needs. A feasibility specialist was hired to support the program in trial design/implementation, barrier tracking, and to serve as a liaison between community site providers, study staff, and the program. Results: Since 2021, 20 clinical studies including 14 interventional treatment trials have been activated demonstrating 108 total patients accrued with 42 interventional accruals; 5 within the full activation model (13 accruals) and 15 in the hybrid model (29 accruals). Patients showed an average of 216 miles, w