The experience of a district general hospital when recruiting patients from across the region into a national study within a rare cancer

ABSTRACT

Introduction: Mesothelioma is a rare cancer with over 2500 cases diagnosed annually in UK. The disease is historically associated with poor survival and high symptom burden. Prior to 2022, there was only one NICE approved NHS treatment option and no agreed, long term second line therapy. Clinical trials investigating new therapies often opened in a small number of specialist centres resulting in significant travel for patients. Harrogate District General Hospital is part of the Harrogate & District NHS Foundation Trust (HDFT) and the smallest organisation within the West Yorkshire & Harrogate Cancer Alliance. Method(s) HDFT became a regional recruitment centre for CONFIRM, a double blinded, single agent immunotherapy versus placebo, clinical trial. Initially aimed at the third line setting, involving a 21 randomisation, HDFT enrolled patients from across the Yorkshire Region. The team included a Consultant Medical Oncologist, 2 Research Nurses, trial administrator and Regional Mesothelioma UK CNS, helping identify the trial and providing additional support to the research nurses and patients recruited. The team had to employ new strategies to manage the complexities involved. At the time, there was no consensus on alternative NHS treatment options. The window of opportunity to enter was often short making good lines of communication with referring teams essential. Co-ordination of appointments to minimise the burden of travel on this vulnerable group of patients was also vital. Result(s) CONFIRM showed improved overall survival in patients with relapsed malignant pleural and peritoneal mesothelioma [1], possibly influencing change in treatment options when NHS England announced interim drug use approvals during the COVID Pandemic [2]. HDFT recruited 18 patients (5.4% of 322 Nationally). 27 patients were referred and approached, 21 consented, 3 failing screening. Conclusion(s) CONFIRM at HDFT demonstrates that small teams can contribute to national research. References [1] Fennell et al. (2021) [2][NHS England (2020) Disclosure No significant relationships.Copyright © 2023 Elsevier B.V.