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Evaluation of the Geographical Accessibility of Genome-Matched Clinical Trials on a National Experience.

Authors
  • Crimini, Edoardo1, 2
  • Tini, Giulia1
  • Tarantino, Paolo1, 2, 3, 4
  • Ascione, Liliana1, 2
  • Repetto, Matteo1, 2
  • Beria, Paolo5
  • Ranghiero, Alberto1
  • Marra, Antonio1
  • Belli, Carmen1
  • Criscitiello, Carmen1, 2
  • Esposito, Angela1
  • Guerini Rocco, Elena1, 2
  • Barberis, Massimo C P1
  • Mazzarella, Luca1
  • Curigliano, Giuseppe1, 2
  • 1 Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. , (Italy)
  • 2 Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. , (Italy)
  • 3 Breast Oncology Center, Dana-Farber Cancer Institute, Boston, MA, USA.
  • 4 Harvard Medical School, Boston, MA, USA.
  • 5 Department of Architettura e Studi Urbani, Politecnico di Milano, Milan, Italy. , (Italy)
Type
Published Article
Journal
The Oncologist
Publisher
Alphamed Press
Publication Date
Feb 02, 2024
Volume
29
Issue
2
Pages
159–165
Identifiers
DOI: 10.1093/oncolo/oyad229
PMID: 37669224
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Molecular-driven oncology allows oncologists to identify treatments that match a cancer's genomic profile. Clinical trials are promoted as an effective modality to deliver a molecularly matched treatment. We explore the role of geographical accessibility in Italy, and its impact on patient access to clinical trials. We retrospectively reviewed molecular data from a single-institutional case series of patients receiving next-generation sequencing testing between March 2019 and July 2020. Actionable alterations were defined as the ones with at least one matched treatment on Clinicaltrials.gov at the time of genomic report signature. We then calculated the hypothetical distance to travel to reach the nearest assigned clinical trial. We identified 159 patients eligible for analysis. One hundred and one could be potentially assigned to a clinical trial in Italy, and the median distance that patients needed to travel to reach the closest location with a suitable clinical trial was 76 km (interquartile range = 127.46 km). Geographical distribution of clinical trials in Italy found to be heterogeneous, with Milan and Naples being the areas with a higher concentration. We then found that the probability of having a clinical trial close to a patient's hometown increased over time, according to registered studies between 2015 and 2020. The median distance to be travelled to the nearest trial was generally acceptable for patients, and trials availability is increasing. Nevertheless, many areas are still lacking trials, so efforts are required to increase and homogenize the possibilities to be enrolled in clinical trials for Italian patients with cancer. © The Author(s) 2023. Published by Oxford University Press.

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