Cancer Centers Pioneer Decentralized Clinical Trial Models to Expand Patient Access Nationwide
核心洞察
UNC Lineberger Comprehensive Cancer Center launches hybrid decentralized trials with $250,000 federal funding to serve North Carolina's 33% rural population, reducing travel barriers to Chapel Hill.
City of Hope (搜索) introduces a national clinical trials model operating through a centralized hub across 37 locations, enabling simultaneous trial openings across multiple states.
Both initiatives demonstrate early success with improved patient enrollment and retention, addressing geographic disparities in cancer (搜索) clinical trial access.
Two major cancer (搜索) centers are revolutionizing clinical trial access through innovative decentralized models designed to eliminate geographic barriers that prevent patients from accessing experimental treatments. UNC Lineberger Comprehensive Cancer Center and City of Hope (搜索) have independently developed approaches that bring clinical trials closer to patients' homes, addressing the critical gap in cancer care accessibility across rural and underserved communities.
UNC Lineberger's Hybrid Decentralized Model
UNC Lineberger Comprehensive Cancer Center has launched a hybrid decentralized clinical trial model specifically targeting North Carolina's rural population, where 33% of residents live in rural communities with limited access to cancer (搜索) treatment trials. The initiative, led by J. Kaitlin Morrison, executive director of clinical research, and Dr. Carrie Lee, chief medical officer, represents a fundamental shift from traditional centralized trial models.
"We at the cancer (搜索) center have a mission to serve the whole state, and we need to find a way to do that," Morrison explained, highlighting the geographic challenges faced by patients traveling to Chapel Hill for treatment.
The hybrid model allows most care and follow-up to occur at hospitals or clinics near patients' homes, with visits to Chapel Hill limited to complex procedures, specialized tests, or expertise in experimental treatments. This approach addresses significant travel burdens, such as the nearly four-hour drive faced by patients from UNC Health Pardee (搜索) in Hendersonville.
Supported by $250,000 in federal funding, including support from the Food and Drug Administration (搜索)'s Office of Minority Health and Health Equity, the team launched the Hybrid Operations to Promote Equity – Bringing Trials Closer to Patients (HOPE) study in 2024. The initiative currently has two trials enrolling patients with 20 more in development.
Statewide Community Engagement
The implementation involved an extensive fact-finding mission called the HOPE Tour, covering nearly 1,300 miles across North Carolina. The team visited nine hospitals, from UNC Health Blue Ridge (搜索) in Morganton to Novant Health New Hanover Regional Medical Center (搜索) in Wilmington, meeting with 120 local administrators and providers over eight months ending in March.
"This approach could improve patient comfort and convenience and reduce geographic and socioeconomic barriers to clinical trial participation, and it would focus on minimizing the administrative burden on the participating hospitals," Lee noted. "It also could help improve recruitment and retention of less studied groups, including rural residents, older adults and those with limited access to care, as well as expedite the overall accrual process."
City of Hope's National Clinical Trials Network
City of Hope (搜索) has launched a complementary but distinct national clinical trials model designed to expand access across the entire United States. As the first academic center with a national clinical trial network serving a large and diverse patient population, City of Hope operates through a single centralized hub with multiple research locations.
The model enables simultaneous clinical trial openings across multiple states with centralized support, addressing traditional limitations including geographic restrictions, enrollment timelines, resource availability, and on-site expertise requirements.
"Our North Star is to offer all our patients, regardless of where they live, the opportunity to participate in clinical trials, which provide them with promising new treatment options long before they become the standard of care," said Edward S. Kim, M.D., M.B.A., vice physician-in-chief at City of Hope (搜索) National Medical Center and system director of Clinical Trials.
Expanding Geographic Reach
With 37 locations across the United States, including premier cancer (搜索) centers in Orange County, Phoenix, Chicago, and Atlanta, City of Hope (搜索) now places millions of Americans within 90 minutes of a treatment site. The organization's distributed, digitally connected network can accommodate rapid expansion without requiring core system overhauls.
"Currently, the gap between those who can access therapeutic breakthroughs and those who can't is widening and in many cases the issue is simply due to the zip code they reside in," explained Marcel van den Brink, M.D., Ph.D., president of City of Hope (搜索) Los Angeles and City of Hope National Medical Center.
Early Results and Industry Impact
Both models are demonstrating measurable success in their initial phases. City of Hope (搜索) reports that nine clinical trials across solid tumors (搜索) and blood cancers (搜索) are currently running at 12 sites, with patient enrollment ahead of expectations. The studies are expected to reach their enrollment targets efficiently.
UNC Lineberger's initiative has gained national recognition, with Morrison receiving second place for her research abstract on the hybrid clinical trials initiative at the Association of American Cancer (搜索) Institutes' clinical research innovation meeting in Chicago in June.
Pharmaceutical Industry Collaboration
The models are attracting pharmaceutical industry support. Eli Lilly and Company is collaborating with City of Hope (搜索) on a Phase 2 clinical trial for relapsed or refractory chronic lymphocytic leukemia (搜索)/small lymphocytic lymphoma (搜索), now open at eight City of Hope locations nationwide.
"We are thrilled to collaborate with City of Hope (搜索) to help pioneer this leading-edge model," said John Pagel, M.D., Ph.D., Senior Vice President of Clinical Development and Global Head of Hematology at Eli Lilly and Company. "The new centralized model saves time and resources and has potential to lead to higher quality research and contribute to our ability to rapidly advance scientific innovation that can make a meaningful difference for patients."
Technology Integration and Future Development
City of Hope (搜索) is developing advanced technological solutions to support its model, including AI and predictive tools integrated into their portal system. These tools will help determine patient geographic distribution and identify optimal locations for specific trials.
The regulatory, operational, and digital frameworks developed by City of Hope (搜索) are designed to accommodate new trial sites globally, representing a scalable approach to clinical trial expansion.
"City of Hope (搜索) has built an all-in-one model that can not only keep up with the pace of our scientific research and clinical innovations, but also support our investigators and collaborators, and ultimately how we deliver care and most importantly, hope, to our patients, regardless of where they are," Dr. Kim concluded.