Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Differences in cancer clinical trial characteristics between metropolitan and rural trial sites in Victoria, Australia (#354)

Narelle McPhee 1 , Michael Leach 2 , Claire Nightingale 3 , Samuel Harris 4 , Eva Segelov 5 6 , Eli Ristevski 7
  1. Bendigo Cancer Centre, Bendigo Health, Bendigo, Victoria, Australia
  2. School of Rural Health, Monash University, Bendigo, Victoria, Australia
  3. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  4. Department of Medical Oncology, Bendigo Health, Bendigo, Victoria, Australia
  5. Department of Oncology, Monash University, Clayton, Victoria, Australia
  6. Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Monash University, Clayton, Victoria, Australia
  7. Monash University, Monash Rural Health, Warragul, Victoria, Australia

Aim: To examine whether characteristics of rural Victorian cancer clinical trials (CCTs) differ from those of metropolitan Victorian CCTs.

Methods:  Using Clinical Trials Management Scheme data sourced from Cancer Council Victoria, we produced cross-tabulations of CCT location (metropolitan/rural) by six trial characteristics: trial phase, tumour stream, intervention, sponsorship type, and numbers of new and follow-up participants per trial (participants/trial). The metropolitan-to-rural ratio was calculated for each characteristic category. Mean/average (standard deviation [SD]; range) numbers of participants/trial were also calculated by location. Pearson’s chi-squared tests were performed to check for differences in characteristics between metropolitan and rural sites (p-value<0.05). Trial site locations were categorised using the Modified Monash (MM) Model.  

Results: Data were obtained from 43 trial units. Seven were rurally located (MM2-7). Overall, 1,501 CCTs (90%) were conducted at metropolitan sites and 168 (10%) at rural sites.  For every nine trials available at a metropolitan site, one was available at a rural site.  On average, metropolitan sites had 1.2 (SD=2.8; range=0-42) new and 2.5 (SD=7.3; range=0-189) follow-up participants/trial while rural sites had 0.8 (SD=1.8; range=0-10) new and 1.13 (SD=2.3; range=0-12) follow-up participants/trial.  Statistically significant differences between metropolitan and rural sites were observed for all trial characteristics except for trial intervention and the number of new participants/trial. For each characteristic, the largest differences in CCT availability between metropolitan and rural sites were: other haematological trials (37:1), phase I trials (24:1), >6 participants/trial (new: 19:1; follow-up: 16:1), commercially sponsored trials (11:1), and non-drug intervention trials (10:1).  Rural sites had no trials available for head and neck cancer, sarcoma and cancers of the central nervous system.

Conclusion: Outside metropolitan Victoria, there is reduced availability and mix of CCTs.  Rural cancer patients who wish to participate in CCTs need to travel to metropolitan trial sites where a larger number and variety of CCTs are available.