Commitment to Inclusion in Cancer Clinical Trials

Abstract image of silhouettes of faces

We are committed to providing compassionate cancer care of the highest quality to our diverse community, by listening to and learning from our patients and their families, providing staff training and education in cultural competency and practicing cultural humility and continually seeking to identify and reduce barriers to enrollment in our clinical trials. We are identifying barriers and developing solutions related to clinical trial outreach, referral and screening, enrollment, and continuity of care for all individuals with the goal of increasing the participation of underrepresented groups in CCR’s clinical research studies. Our major areas of focus are:

Assess and reduce barriers to participation in CCR clinical trials

All who are enrolled in a clinical study receive medical care at the NIH Clinical Center, including diagnostic testing, doctor’s appointments, and treatments at no cost to the patient or insurers. Patients also receive support for travel expenses, food, lodging and outpatient treatment.

CCR recently extended our support to include costs related to a patient’s initial screening or consultation visit. When possible and in the patient’s interest, we will also continue to use telemedicine visits to reduce the time and expense of multiple trips to the clinic.

Be intentional in our effort to reach out to diverse patient populations

CCR has engaged with potential partners like the Veterans’ Administration to explore closer coordination of patient referrals and care and to increase awareness of our clinical trials to a broader, more varied range of patients.

CCR encourages the translation of protocol consent documents in Spanish and other languages to ensure our patients understand their treatments and can effectively communicate with their caregivers and clinical care teams.

We strive to recruit diverse populations onto our trials. If we can understand differences in disease onset and progression in specific populations, we could potentially see different outcomes. - Fatima Karzai, M.D., Associate Research Physician, Genitourinary Malignancies Branch

Broaden the eligibility criteria for our clinical trials to maximize accessibility

In response to requests from physicians and advocates, the NCI Cancer Therapy Evaluation Program (CTEP) recommended expanded eligibility criteria and CCR will adopt these as the default standard for every new drug clinical trial. The changes increase the likelihood that patients would qualify for a trial despite:

  • Advanced age
  • HIV infection
  • Cancer that has spread to the brain
  • Organ dysfunction
  • Prior or additional cancers  

Build partnerships with local community organizations and leaders

In addition to national efforts, we will increase our efforts to engage healthcare professionals and patients within CCR’s local geographic area (District of Columbia, Maryland, Virginia) to better understand their needs and provide accessible information and resources about CCR’s clinical program, available clinical trials, and how to access/refer to them.

We will identify ways to support our physicians to enable consistent, clear, and timely communication with referring providers to foster a foundation of good medical practice and build recurring patient referrals.

Provide continuing education for our medical providers on issues around cultural humility and communication with patients and families

CCR will work to expand our use of patient feedback to improve our support and care of our patients.

CCR is exploring options to provide cultural humility training to all our clinical care teams.

Institutional leadership and support

CCR is committed to providing the resources necessary to support a sustained effort to increase the diversity of patients enrolled in our trials.

We have developed a visualization dashboard to enable our clinical leaders to see in real-time the demographics of our patient population and to assess the effectiveness of our outreach.

CCR has initiated a national search for a researcher/leader focused on effective cancer health care delivery for all. This leader will conduct research on the equitable delivery of cancer care in the clinical trials environment, support engagement, access and community outreach, and lead CCR’s continuing efforts to improve quality care for all our patients.