Copyright © 2023 Journal of Oncology Navigation & Survivorship. Reprinted with permission.
To better assist their oncology patients with getting into clinical trials, providers at the University of Florida (UF) Health Cancer Center, Gainesville, recently decided that they needed a new kind of navigator: an oncology clinical trial nurse navigator.
Like any oncology navigator, this new position is based largely on assessing and addressing barriers to care, according to Jennifer West, BSN, RN, CCRC, ONN-CG, a Clinical Trial Navigator, UF Health Cancer Center, who is also a certified research coordinator, a certified oncology nurse navigator, and Co-Chair, Academy of Oncology Nurse & Patient Navigators (AONN+) Clinical Trials Committee. But in this particular role, the hurdles addressed are those standing in the way of patient enrollment on oncology clinical trials.
“Getting into a large referral center like ours comes with a lot of barriers and obstacles,” she said at the AONN+ Midyear Conference in Orlando, FL. “So we developed this position, which basically combines both of my skill sets, and we’ve had it now for about a year.”
As the new clinical trial nurse navigator, some of Ms West’s responsibilities include:
According to Ms West, a large number of patients in the Southeast come to UF Health for second opinions and want to get on clinical trials at her facility, but a multitude of barriers often stand in their way.
“They started this position for me to assess those barriers up front, and to see if we could help increase enrollment to clinical trials,” she explained.
On the NaviGATOR website, patients can see specifically which clinical trials are available according to their cancer type and stage, and they can call or send an email directly to Ms West to inquire about any trials they think they might be eligible for.
“We get them on the phone within 24 hours, and we talk to them about what we have to offer at our facility,” she said.
During that initial conversation with the patient, Ms West immediately begins to assess any barriers that can be addressed early on to more quickly enroll them onto a clinical trial.
She then works with the facility’s research team to obtain any outside records (ie, clinical records, scans, genetic testing, molecular testing, etc), so all records are on hand before the patient even reaches their facility.
An important aspect of her role is communicating with the facility’s research coordinators about potential trial candidates. She prescreens each day’s clinical schedule and lets the research coordinators know which patients look like they would be eligible for an available clinical trial.
“Probably about 80 patients a day come through our oncology clinics,” she said. “By helping them in this way, the research coordinator and the physician are ready for that patient with options when they come back to clinic.”
Once she has identified a patient who is both interested and eligible for a trial—and has addressed any barriers standing in their way—she hands over care to the research coordinator, who facilitates the remaining steps to get the patient onto the clinical trial.
Once the patient is on the trial and the coordinator takes over, the nurse navigator plays an important role in becoming part of the trial process and facilitating communication between other providers, she said.
When it comes to promoting clinical trial enrollment, nurse navigators should first become familiar with any trials enrolling patients in their specific disease type, and at what stage (ie, neoadjuvant, adjuvant, progression after first-line therapy, etc).
“Be a patient advocate by bringing up clinical trials at tumor boards, and by continuously assessing barriers as you work with patients through their treatment process,” she said. Increase their interest (without attempting to persuade them to participate in a trial), and provide them with the basic knowledge to ask questions of their providers, she advised.
Finally, educate patients, even newly diagnosed patients, on clinical trials. According to Ms West, the fundamental basis of a clinical trial and its ability to move forward with discovering new treatments is patient participation. But first there must be patient education, for which navigators are invaluable.
“A clinical trial doesn’t have to be the last hope for these patients. It can be the first step in their care,” she said. “This is their cancer journey; let’s do everything we can to get them into survivorship.”
