Monash-Bendigo Teletrials Clinic: Facilitating regional patient access to early phase clinical trials.

Abstract

Aim: To facilitate regional oncology patient consideration for early phase clinical trials at Monash Health through telehealth consultations. Methods : Patients identified through weekly Bendigo Health clinical meetings as potentially eligible for Monash Health trials are referred to Monash trials unit with patient consent. Rapid access appointments are available each Friday for telehealth review with Professor Segelov or Dr Ahern, and the patient attends on-site in Bendigo with the Trials fellow. Discussion of potential trial options, review of inclusion/exclusion criteria as well as travel and time commitment involved should allow patients to make an informed decision about subsequently proceeding to an in person visit to Monash Clayton to pursue formal trial enrolment, consent and screening. Pre-screening investigations including pathology, radiology and cardiology testing are organised locally. Results : This streamlined model of care commenced in late October 2020. To date, 14 patients have participated, with: age (range 45-74 years), tumour type (endometrial, colorectal, pancreatic, cholangiocarcinoma and oesophageal) and line of treatment (2nd - 5th). Nine patients had potential trials identified and proceeded to further consultation. Three patients have commenced therapy on trial, with three currently in screening. Six patients continue on standard therapy having had potential future trials identified. Average wait time for an appointment following referral is less than 1 week (range 1 day-2 weeks). Referrals originated from multiple oncologists for patients undergoing treatment at Bendigo and satellite sites (Echuca, Swan Hill, Kerang and Kyneton). Conclusions : As awareness of the model has increased so has the interest in referrals. Some cases have been discussed directly with advice on referral to another institute if places are not available at Monash. This has improved efficiency, reduced unnecessary referrals to multiple hospital trial units, and also reduced uncertainty and wait times for patients. The reach extends beyond the regional centre into more remote satellite clinics.