PracticeUpdate: Haematology & Oncology

NEWS

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Telehealth extension to provide remote cancer patients access to clinical trials Oncologists in Australia will soon be able to offer patients in rural and remote regions greater access to experimental and potentially lifesaving cancer treatments under a new national scheme that will extend access to clinical trials to patients outside major centres.

EDITORIAL Managing Editor Anne Neilson anne.neilson@elsevier.com Editor Carolyn Ng carolyn.ng@elsevier.com Designer Jana Sokolovskaja j.sokolovskaja@elsevier.com Medical Advisor Dr Barry M Dale Consultant Haematologist, Medical Oncologist

T ele-trial – an extension of the telehealth model – will offer rural patients the first opportunity to be enrolled, treated and monitored throughout a clinical trial without having to suffer the prohibitive costs and travel associated with participating in trials only offered in metropolitan areas. Sabe Sabesan, MBBS, FRACP, Chair of the Clinical Oncology Society of Australia’s Rural and Regional Oncology Group and Director of Medical Oncology at the Townsville Cancer Centre, has been the driving force behind the development and roll out of tele-trial. Speaking to Practice Update Haematology & Oncology , Professor Sabesan said the benefits of the new model would not be limited to regional, rural and remote areas. “This model has the potential to connect larger centres even within the same city and improve the rate of recruitment to highly specialised clinical trials, including rare cancer trials.” Professor Sabesan added that residents outside of major centres in Australia continue to struggle to gain access to promising experimental treatments offered in these trials. “These are people who are very sick, who are faced with having to travel long

will promote our capacity to support a wider range of trials,” said Professor Sabesan, who added that, without multi-site collaboration, Australia is less attractive to international trial sponsors, which limits the availability of experimental, lifesaving treatments clinicians are able to offer their patients. He has already received the backing of COSA and other medical professional bodies, big industry players such as Medicines Australia, pharmaceutical companies, hospitals, and research councils including the NHMRC. Professor Sabesan said he is now working with state governments in an effort to streamline the administrative and legal requirements that come with setting up a clinical trial and which currently varies from state to state. While he acknowledged that there is still a lot of work to be done before the model is up and running, Professor Sabesan said he has already made some progress. “If we can use these kinds of models to push for reforms in regulation and governance approval then it can only be a good thing for research as a whole in the country … South Australia, Victoria, New SouthWales and Queensland have already agreed to streamline their contracts and governance processes to support the model,” he said. But rural hospital sites will also have to play a part if the model is to work – and that may mean upgrading facilities and resources and seeking the appropriate trial accreditations. “Many of the rural sites do already have the facilities to be part of a big trial; we just haven’t had the numbers. But if other sites don’t have the resources then they need to create them … but we now have a model that allows for rural patients to be recruited into trials. If rural sites are serious about their patients, they will have to up the ante,” Professor Sabesan concluded. COSA have now released the national implementation guide for the tele-trial model.

distances, sometimes without family friends, and who may have to fork out a lot of money to get to major centres. So many rural and regional patients miss out on potentially lifesaving treatments.” Professor Sabesan has been instrumental in providing medical oncology and medical nursing services to patients with cancer in rural and remote Queensland for close to a decade through the Queensland Remote Chemotherapy Supervision (QReCS) model. QReCS, which Professor Sabesan and his team initially set up for patients in Townsville and which Queensland Health eventually adopted statewide, allows rural generalist nurses to administer chemotherapy at rural sites with the support of the rural generalist doctors and pharmacists, and under the supervision of medical oncologists and chemotherapy nurses from larger centres using telehealth. Under the tele-trial framework, patients from rural or regional sites can be recruited, consented, and even treated and monitored at follow-up visits using web-based systems and video capabilities to connect a primary trial site with smaller satellite sites, creating a trial cluster. “Developing these clinical trial networks through models like the tele-trial concept,

SALES Commercial Manager Fleur Gill fleur.gill@elsevier.com

Account Manager Linnea Mitchell-Taverner l.mitchell-taverner@elsevier.com

Sabe Sabesan

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New drugs and devices listing

THERAPEUTIC GOODS ADMINISTRATION (TGA) www.tga.gov.au Adalimumab (Humira) , Abbvie – uveitis Saxagliptin/dapagliflozin (Qtern 5/10) , AstraZeneca – type 2 diabetes mellitus PHARMACEUTICAL BENEFITS SCHEME www.pbs.gov.au Armodafinil (Nuvigil) , Teva Pharma – narcolepsy, improve wakefulness

Auranofin (Ridaura) , Amdipharma Mercury – rheumatoid arthritis Dexamethasone (Ozurdex) , Allergan – diabetic macular oedema Imatinib (Imatinib-DRLA) , Dr Reddy’s Laboratories – chronic myeloid leukaemia, Ph+ acute lymphoblastic leukaemia, myelodysplastic/myeloproliferative diseases, aggressive systemic mastocytosis, hypereosinophilic syndrome, chronic eosinophilic leukaemia, dermatofibrosarcoma protuberans Ruxolitinib (Jakavi) , Novartis – disease-related splenomegaly or symptoms in myelofibrosis, polycythemia vera Please consult the full Product Information before prescribing.

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VOL. 1 • No. 5 • 2016