The University of Southern California (USC) Norris Comprehensive Cancer Center has launched a study to determine how financial assistance for costs associated with clinical trial participation might increase enrollment, particularly among low-income patients and racial and ethnic minorities. The study, known as Improving Patient Access to Cancer Clinical Trials (IMPACT), assesses social and cultural barriers to clinical trial participation.
Fewer than 5% of adult patients with cancer participate in clinical trials nationally, with ethnic and racial minorities enrolling at even lower rates. Economic concerns play a role in the lower participation, as low-income patients may lack adequate financial resources to pay for travel, childcare, and time away from work.
The discovery of potentially life-prolonging therapies may be delayed, and patients may miss out on promising treatments as a result of chronic underenrollment. Low diversity in clinical trials also creates a lack of data on the nuances of personalized cancer treatment within underrepresented groups.
Darcy Spicer, MD
Through IMPACT, all patients who qualify for a clinical trial at USC Norris are offered the opportunity to apply for a reimbursement program for out-of-pocket expenses associated with clinical trial participation, including travel and lodging. This includes patients seen at Los Angeles County + USC Medical Center; the USC Norris Treatment Center in Newport Beach; California, and anyone referred to USC Norris by affiliates and partners. Reimbursement is based on a sliding scale up to seven times the U.S. federal poverty guidelines, and information will be available in multiple languages to encourage diversity in clinical trial participation.
“USC Norris is situated in an area of rich diversity, thus our physicians and researchers are uniquely positioned to gather vital statistics in populations that might otherwise go uncovered,” said principal investigator of IMPACT Darcy Spicer, MD, Associate Professor of Clinical Medicine at the Keck School of Medicine of USC and Chief of Medical Oncology at USC Norris. “We are hopeful that this study provides more people with access to burgeoning clinical innovations, while informing the scientific community about the most effective means to treat cancer.”
The potential benefits of clinical trials should not be the limited privilege of those with the knowledge, time, and resources to navigate their complexities.— Dana Dornsife
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IMPACT is a collaboration with the Lazarex Cancer Foundation, reportedly the only nonprofit in the United States that assists both adult and pediatric patients with finding clinical trials and reimburses them for the out-of-pocket travel costs of participating. In 2018, at the urging of the Foundation, the U.S. Food and Drug Administration issued new guidance allowing pharmaceutical companies to reimburse patients for travel costs to get to clinical trials, although not all trial sponsors do this.
“The potential benefits of clinical trials should not be the limited privilege of those with the knowledge, time, and resources to navigate their complexities,” said Dana Dornsife, Founder and Board Chair of Lazarex Cancer Foundation. “With more than 1.5 million people receiving a cancer diagnosis each year, it is imperative that we develop a model that hastens the speed of innovation, while ensuring broad access to care.” ■