Poster Presentation NSW State Cancer Conference 2023

Patient Access to Phase 1 Clinical Trials: the Scientia Experience (#187)

Charlotte Lemech 1 , Christina Teng 1 , Andrew Killen 1 , Shiena Lemin 1 , Belinda Bahari 1
  1. Scientia Clinical Research, Randwick, NSW, Australia

Aim:

To identify and summarise the demographic factors of patients referred to Scientia Clinical Research (SCR) Phase 1 oncology trials.

Background:

Phase 1 trials are first-in-human studies evaluation the safety, efficacy and pharmacokinetics of newly developed medications. SCR is a dedicated Phase 1 trial unit located in NSW, Australia.

Methods:

Descriptive statistics were used to summarise data from the clinical records of patients referred to the SCR Phase 1 unit, including:

  1. date of referral and consultation
  2. referrer
  3. postcode
  4. patient date of birth
  5. patient diagnosis

 

Results:

In the 2022 calendar year, 168 patients were referred to SCR for an opinion about early phase clinical trials, from 51 referrers.   Of those referred, 139 patients had a first consultation.  Reasons for not proceeding with a consultation included; no formal referral provided for 15 patients, 9 patients declined a consultation, 3 patients died prior to consultation, 2 patients were uncontactable.  The mean age at time of referral was 59 years, (standard deviation 12, median 61, range 12-83). 

The most common primary diagnoses were upper gastrointestinal (29%), colorectal (23%)  and gynaecological (23%) cancers.  Others are represented in table/fig 1.

Figure 1. Cancer diagnosis of patients referred to phase 1 trials

 Of the patients where referral location was available, the majority resided in metropolitan Sydney (47%). Regional NSW residents comprised 29% and interstate referrals 9%.  Referrals by regional site is represented in figure 2 (table and ‘heat map’).

Figure 2. Local Health District (LHD) of origin (by postcode) for patients referred to phase 1 trials

The median time between referral and first consultation was 10 days, (interquartile range 13), [mean 14, SD13].   (Fig 3)

Figure 3. Time from referral and first conusltation

Five initial consultations were conducted with the assistance of an interpreter (3 Mandarin, 1 Cambodian, 1 AUSLAN). 

Conclusion:

In 2022, SCR referrals demonstrated strong representation from regional NSW, while CALD patients from culturally and linguistically diverse backgrounds were under-represented.  Patients with gastrointestinal malignancies constituted the bulk of referrals, reflecting a high unmet clinical need for therapeutic options in these patients.