Increasing Clinical Trial Access Across Australia


Pictured: Dr Rob Zielinski at the Orange Hospital. Photo by Central Western Daily

The Clinical Oncology Society of Australia (COSA)'s pilot implementation of the Australasian Tele-Trial Model uses tele-health or videoconferencing technology to support patients living outside major metropolitan centres to access clinical trials in their areas. The project has received funding from the MTPConnect Project Fund Program to implement a feasible and effective tele-health strategy to increase access to clinical trials closer to home, while at the same time ensuring the proper conduct of cancer clinical trials.

COSA’s Executive Officer Marie Malica said funding from MTPConnect’s Project Fund Program will enable COSA to pilot the Tele-Trial Model in several sites in Australia.

“MTPConnect project funding has meant COSA can offer funding to five primary sites in NSW, Victoria and Queensland to assist them to establish the Tele-Trial Model,” Ms Malica explained.

“Successfully establishing the Model at these sites will pave the way for the Model to be adopted nationally and potentially transform the conduct of clinical trials in Australia.”

Factors such as the increased cost and inconvenience of travel to major metropolitan centres and limited availability to trial sites, are barriers that patients living in rural Australia face. COSA understands that establishing clinical trial units in larger regional cancer treatment centres can be done, however, the logistics of maintaining a suitably trained workforce and undertaking the ethical and regulatory responsibilities of clinical trials may be difficult in smaller rural and regional sites.

This is due to limited resources at sites as well as small patient numbers. The adoption of the Australasian Tele-Trial Model will enable rural and regional sites with limited resources to provide access to Phase III comparative effectiveness studies, and potential trials of new and novel therapies for the local population.

COSA is aligned with MTPConnect’s 10-year Sector Competitiveness Plan (SCP) in fostering an environment for rural clinical trials to flourish across Australia. The Tele-Trial Model is a framework designed to improve patients’ access to clinical trials and to facilitate collaboration between clinicians at larger regional hospitals and smaller rural hospitals. In partnership with Queensland Health, COSA is also addressing reform of some of the duplicative and costly regulatory processes in clinical trials to ultimately increase recruitment nationally and reduce the disparity in cancer outcomes for geographically dispersed populations.

In addition to the sites funded by the COSA Tele-Trials Project the Tele-Trial Model has been trialed in two rural NSW sites (Orange and Dubbo). Orange Hospital, as the primary site, is working with Dubbo Hospital as a satellite site to facilitate access to the ASCOLT study that is an Australasian Gastro-Intestinal Cancer Trials Group (AGITG) sponsored clinical trial for bowel cancer. In December 2017, the first patient was enrolled on the ASCOLT study and to date there are now three patients recruited.

Orange Clinical Trials Centre’s Medical Oncologist Dr Rob Zielinski said the Tele-Trial model “will reshape the existing way we run cancer clinical trials.”

“It’s all about improving access and this model will deliver and although the idea is a simple one it requires significant support across multiple industry, political and health bureaucratic layers,” Dr Zielinski explained.

“To date that support has been overwhelmingly positive and I am excited about this approach to running clinical trials because my patients are now participating in research to improve upon the standards of cancer care.

“This model when successful in Australia can be rolled out internationally thus improving cancer care for patients across the globe.”

Using the Tele-Trial Model for the ASCOLT trial has seen positive results as it has saved patients significant travel time, as well as giving oncologists the opportunity to network, increase communication and collaboration between Orange and Dubbo. Dubbo clinicians have expressed enthusiasm for the Model as they are seeing the benefits first-hand of running clinical trials in their area.

Dubbo Hospital’s Medical Oncologist Dr Florian Honeyball said tele-trials have allowed his patients in remote and regional settings to access clinical trials.

“[Tele-Trials] are really opening up a whole new area of therapy for people who would otherwise not be able to access up-to-date cancer care,” Dr Honeyball explained.

COSA is hoping that the Model will be adopted nationally making Australia a more attractive and competitive clinical trial destination.

For more information on COSA and its Australasian Tele-Trial Model, visit www.cosa.org.au.