The City of Boston is rich with academic medical centers and cancer care facilities. However, these resources have done little to reduce racial and ethnic disparities in cancer mortality, in part due to a lack of minority enrollment in cancer clinical trials. Boston Medical Center (BMC), the largest safety net provider in New England, stands uniquely positioned to implement a Minority-Based Community Clinical Oncology Program (MB- CCOP) in attempts to reduce this disparity. More than two-thirds of BMC patients are minorities and most are low-income. BMC already has a successful Cancer Clinical Trials Program (CCTP) and a state-of-the-art cancer center that opened in 2006. Established in 1991, the BMC CCTP has developed methods for culturally sensitive outreach, recruitment, enrollment and retention in cancer clinical trials. Our CCTP research nurses have all been trained in patient navigation to help patients overcome their many barriers to care. As a result, minorities now account for 42% of cancer clinical trial enrollment. However, the lack of resources in our CCTP limits the extent to which we can offer our services beyond the confines of the institution into Boston's most impoverished and diverse communities. The MB-CCOP at BMC will provide the resources we need to facilitate access to both BMC's cancer care services and cancer clinical trials by patients receiving primary care in the community. Taking advantage of the experience at BMC with the NCI Patient Navigator Research Program, we will employ a patient navigation model for the BMC MB-CCOP. Navigators will be placed at five of Boston's community health centers (CHCs) to facilitate the communication process and the referral of appropriate patients for evaluation of clinical trials at BMC. At the same time, an MB-CCOP at BMC will provide our oncologists access to a much larger portfolio of cancer clinical trials relevant to the patient population we serve.
Our specific aims are: 1) to provide patient navigation for CHC patients to facilitate access to BMC cancer care and clinical trials;2) to promptly screen all cancer patients for clinical trial participation;3) to provide outreach and education to community physicians and their patients, and 4) to test the effectiveness of these methods in increasing minority accruals.

Public Health Relevance

The overarching goal of the MB-CCOP at BMC is to enhance minority enrollment to cancer clinical trials utilizing community-based patient navigation in an effort to reduce the racial and ethnic disparities of cancer mortality in Boston.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
3U10CA139519-02S1
Application #
8326769
Study Section
Special Emphasis Panel (ZCA1-SRLB-Y (J1))
Program Officer
Hadley, James
Project Start
2010-06-01
Project End
2013-05-31
Budget Start
2011-09-08
Budget End
2012-05-31
Support Year
2
Fiscal Year
2011
Total Cost
$140,000
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
02118
Yao, James C; Guthrie, Katherine A; Moran, Cesar et al. (2017) Phase III Prospective Randomized Comparison Trial of Depot Octreotide Plus Interferon Alfa-2b Versus Depot Octreotide Plus Bevacizumab in Patients With Advanced Carcinoid Tumors: SWOG S0518. J Clin Oncol 35:1695-1703
Durie, Brian G M; Hoering, Antje; Abidi, Muneer H et al. (2017) Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial. Lancet 389:519-527
Ko, Naomi Yu; Battaglia, Tracy A; Gupta-Lawrence, Rebecca et al. (2016) Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey. BMC Health Serv Res 16:196
Unger, Joseph M; Hershman, Dawn L; Arnold, Kathryn B et al. (2016) Stepwise development of a cancer care delivery research study to evaluate the prevalence of virus infections in cancer patients. Future Oncol 12:1219-31
Battaglia, Tracy A; Gunn, Christine M; McCoy, Molly E et al. (2015) Beliefs About Anal Cancer among HIV-Infected Women: Barriers and Motivators to Participation in Research. Womens Health Issues 25:720-6
Philip, Philip A; Goldman, Bryan; Ramanathan, Ramesh K et al. (2014) Dual blockade of epidermal growth factor receptor and insulin-like growth factor receptor-1 signaling in metastatic pancreatic cancer: phase Ib and randomized phase II trial of gemcitabine, erlotinib, and cixutumumab versus gemcitabine plus erlotinib (SWO Cancer 120:2980-5