Movember: Make It About Access
November 9, 2021

It’s Movember again - and every year I’m surprised and delighted to see the proliferation of mustaches to help draw attention to men’s health issues like prostate and testicular cancer, as well as mental health issues.  At Curebase, our mission is that any patient, anywhere can be in a clinical trial at home and/or with their own doctor.  We want clinical trials to become part of the standard of care.


And in Movember that means access to care for men who would not otherwise seek medical care.   I mean, they would not seek medical care for symptoms, because they are not really getting any medical care or oversight.  They’ve opted out, or they can’t afford the time or money to go see a doctor.  There may be social or cultural issues that are also barriers to those men seeking medical advice and or treatment.  


That gap in medical care has a very serious impact on medical outcomes for those who delay or even avoid seeing a doctor.  


The Facts:


African American (AA) men are more likely to develop prostate cancer and nearly 2.5 times more likely to die of it than their Caucasian counterparts (1,2).  That’s the biggest disparity in outcomes in any malignancy - and prostate cancer is the most common malignancy that presents in males (1,2).  In some US states, the mortality rate for African American men is 3 times that of Caucasian males (1).  AA men are less likely than Caucasians to undergo screening, so are more likely to be diagnosed with advanced disease, have longer delays from diagnosis to treatment, and are less likely to receive aggressive treatment (1).


Figure 1. Rates of prostate cancer incidences and deaths in AA and Caucasian men(2)

What’s going on?


Well, as usual, it’s complicated.  Some of the reasons for these differences are beyond what us trial technologists and innovators can solve, like differences in income and education levels.  But some of the issues are exactly aligned with our purpose at Curebase.  We want to make it much easier for anyone who wants to be in a trial to be able to join one.  And we want to make it easy for that person to participate in the way that fits their needs, while aligning to the scientific rigor needed for the trial.  Most of all, we aim for clinical trials, or at least the will to contribute to research data, to become a norm in clinical care. 


So, how does a young Decentralized Clinical Trial (DCT) company think it can make a difference to this systemic inequity?


First - let’s think about these men and what they need to seek care earlier.


They need to believe that the health care system is acting in their best interest. If they have a relationship with a doctor, any doctor, let’s put the information about early access to care, and trial options, in the hands of both the patient and the doctor.


Patients tell us (again and again!) that they want to hear about trials from their doctors.  If you don’t see a doctor regularly, could we flip that, and put the information in the hands of the patient so they inform their doctor when and if they do seek care?  


Figure 2. Prostate cancer clinical trial participation data and barriers to access (3)

Then, let’s find ways to involve that trusted doctor to stay with the patient while he gets the initial information to understand any symptoms, and to consider treatment options.  That means making the information easy to access and easy to understand.  At Curebase we want the treating doctor to stay on the journey with the patient when he or she decides to enter a trial. The treating doctor can work remotely with a full-fledged investigator, so that the trusted relationship persists, the doctor understands what’s going on with the patient during the trial, and can even conduct some of the standard of care assessments in the trial, with the appropriate training and oversight.  And let’s ensure that as many aspects of the trial as possible are made to fit the patient’s preference.  How much can we do at home?  How much can we do with telemedicine linking the patient, their trusted MD and a study investigator?  

Trust is a major part of health care, and we believe that by connecting treating MDs / PCPs to trials we can truly make a difference for patients who don’t get regular access to care. That matters - a lot.  Delays in care have a huge impact on outcomes.   A recent study conducted by the NIH and Department of Defense shows that when patients get similar access to care and treatment through an agency like the VA there is no difference in mortality between African American and Cauacasian prostate cancer patients (4).


So, in Movember,  make some of your actions all about access.  Everyone deserves access to care.  Clinical trials can be a big part of that care equation if we make them more accessible to those who don’t seek medical care routinely.  Shifting that to build trust and better care options will have a huge impact on patient access and outcomes.  



References:

  1. Stokes WA, Hendrix LH, Royce TJ, Allen IM, Godley PA, Wang AZ, & Chen RC. Racial differences in time from prostate cancer diagnosis to treatment initiation: a population-based study. Cancer 2013; 119: 2486–2493. DOI: https://doi.org/10.1002/cncr.27975.
  2. Siegel DA, O’Neil ME, Richards TB, Dowling NF, Weir HK. Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity — United States, 2001–2017. MMWR Morb Mortal Wkly Rep 2020;69:1473–1480. DOI: http://dx.doi.org/10.15585/mmwr.mm6941a.
  3. Vince R, Spratt, DE. Drivers of racial disparities in prostate cancer trial enrollment. Prostate Cancer Prostatic Dis 2021. https://doi.org/10.1038/s41391-021-00427-z.
  4. Riviere P, Luterstein E, Kumar A, et al. Survival of African American and non-Hispanic white men with prostate cancer in an equal-access health care system. Cancer 2020;126:1683–90. DOI: https://doi.org/10.1002/cncr.32666.

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The Curebase Blog

Movember: Make It About Access

November 9, 2021

Jane Myles, VP of Clinical Trial Innovation at Curebase, highlights how decentralizing clinical trials can improve access to medical care and equity in men's health.

It’s Movember again - and every year I’m surprised and delighted to see the proliferation of mustaches to help draw attention to men’s health issues like prostate and testicular cancer, as well as mental health issues.  At Curebase, our mission is that any patient, anywhere can be in a clinical trial at home and/or with their own doctor.  We want clinical trials to become part of the standard of care.


And in Movember that means access to care for men who would not otherwise seek medical care.   I mean, they would not seek medical care for symptoms, because they are not really getting any medical care or oversight.  They’ve opted out, or they can’t afford the time or money to go see a doctor.  There may be social or cultural issues that are also barriers to those men seeking medical advice and or treatment.  


That gap in medical care has a very serious impact on medical outcomes for those who delay or even avoid seeing a doctor.  


The Facts:


African American (AA) men are more likely to develop prostate cancer and nearly 2.5 times more likely to die of it than their Caucasian counterparts (1,2).  That’s the biggest disparity in outcomes in any malignancy - and prostate cancer is the most common malignancy that presents in males (1,2).  In some US states, the mortality rate for African American men is 3 times that of Caucasian males (1).  AA men are less likely than Caucasians to undergo screening, so are more likely to be diagnosed with advanced disease, have longer delays from diagnosis to treatment, and are less likely to receive aggressive treatment (1).


Figure 1. Rates of prostate cancer incidences and deaths in AA and Caucasian men(2)

What’s going on?


Well, as usual, it’s complicated.  Some of the reasons for these differences are beyond what us trial technologists and innovators can solve, like differences in income and education levels.  But some of the issues are exactly aligned with our purpose at Curebase.  We want to make it much easier for anyone who wants to be in a trial to be able to join one.  And we want to make it easy for that person to participate in the way that fits their needs, while aligning to the scientific rigor needed for the trial.  Most of all, we aim for clinical trials, or at least the will to contribute to research data, to become a norm in clinical care. 


So, how does a young Decentralized Clinical Trial (DCT) company think it can make a difference to this systemic inequity?


First - let’s think about these men and what they need to seek care earlier.


They need to believe that the health care system is acting in their best interest. If they have a relationship with a doctor, any doctor, let’s put the information about early access to care, and trial options, in the hands of both the patient and the doctor.


Patients tell us (again and again!) that they want to hear about trials from their doctors.  If you don’t see a doctor regularly, could we flip that, and put the information in the hands of the patient so they inform their doctor when and if they do seek care?  


Figure 2. Prostate cancer clinical trial participation data and barriers to access (3)

Then, let’s find ways to involve that trusted doctor to stay with the patient while he gets the initial information to understand any symptoms, and to consider treatment options.  That means making the information easy to access and easy to understand.  At Curebase we want the treating doctor to stay on the journey with the patient when he or she decides to enter a trial. The treating doctor can work remotely with a full-fledged investigator, so that the trusted relationship persists, the doctor understands what’s going on with the patient during the trial, and can even conduct some of the standard of care assessments in the trial, with the appropriate training and oversight.  And let’s ensure that as many aspects of the trial as possible are made to fit the patient’s preference.  How much can we do at home?  How much can we do with telemedicine linking the patient, their trusted MD and a study investigator?  

Trust is a major part of health care, and we believe that by connecting treating MDs / PCPs to trials we can truly make a difference for patients who don’t get regular access to care. That matters - a lot.  Delays in care have a huge impact on outcomes.   A recent study conducted by the NIH and Department of Defense shows that when patients get similar access to care and treatment through an agency like the VA there is no difference in mortality between African American and Cauacasian prostate cancer patients (4).


So, in Movember,  make some of your actions all about access.  Everyone deserves access to care.  Clinical trials can be a big part of that care equation if we make them more accessible to those who don’t seek medical care routinely.  Shifting that to build trust and better care options will have a huge impact on patient access and outcomes.  



References:

  1. Stokes WA, Hendrix LH, Royce TJ, Allen IM, Godley PA, Wang AZ, & Chen RC. Racial differences in time from prostate cancer diagnosis to treatment initiation: a population-based study. Cancer 2013; 119: 2486–2493. DOI: https://doi.org/10.1002/cncr.27975.
  2. Siegel DA, O’Neil ME, Richards TB, Dowling NF, Weir HK. Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity — United States, 2001–2017. MMWR Morb Mortal Wkly Rep 2020;69:1473–1480. DOI: http://dx.doi.org/10.15585/mmwr.mm6941a.
  3. Vince R, Spratt, DE. Drivers of racial disparities in prostate cancer trial enrollment. Prostate Cancer Prostatic Dis 2021. https://doi.org/10.1038/s41391-021-00427-z.
  4. Riviere P, Luterstein E, Kumar A, et al. Survival of African American and non-Hispanic white men with prostate cancer in an equal-access health care system. Cancer 2020;126:1683–90. DOI: https://doi.org/10.1002/cncr.32666.

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At Curebase we are rapidly expanding and preparing for the wave of decentralization in clinical trials that we intend to lead. To that end we have recently hired a Director of Clinical Operations, Adam Samson...

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Movember: Make It About Access
November 9, 2021

Jane Myles, VP of Clinical Trial Innovation at Curebase, highlights how decentralizing clinical trials can improve access to medical care and equity in men's health.

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Curebase is increasing diversity in clinical research by engaging more patients in real-world data collection

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