Cancer Care Equity
Collaboration expands clinical trials in the Deep South
April 26, 2023
A collaboration between Baptist Memorial Health Care Corporation and Vanderbilt-Ingram Cancer Center is providing access to clinical research for people in the Deep South and expanding the research missions for both institutions.
Memphis-based Baptist has a network of 22 hospitals and 25 cancer centers with 13 of those oncology clinics in smaller cities of Mississippi, Arkansas and Tennessee where people historically had to travel hundreds of miles to a National Cancer Institute (NCI)-Designated Cancer Center to participate in clinical trials. Their options for access to emerging innovations in cancer care had been limited or nonexistent.
Baptist began broadening their options in 2012 when it entered into an academic affiliation agreement with Vanderbilt-Ingram. Two years later, Baptist became a National Cancer Institute Community Oncology Research Program (NCORP) site for minority and underserved populations. Over the past decade, the affiliation has secured major grants, launched a recruitment initiative to enroll historically underserved patients in blood cancer clinical trials, set up tumor board conferences to consult on patient cases, and held a series of webinars for oncologists to share expertise with one another. Physicians from Baptist and Vanderbilt-Ingram have partnered on research collaborations and held joint community outreach and engagement events. A primary goal is to improve health outcomes for people of color and rural residents.
The affiliation parallels the mission to democratize precision oncology, a primary goal for Ben Ho Park, MD, PhD, the Benjamin F. Byrd Jr. Professor of Oncology and director of Vanderbilt-Ingram.
“Highly personalized cancer care should be available to people of all racial and demographic backgrounds,” Park said. “It should not be limited to people who live in well-resourced or urban areas. Increasingly, clinical trials are designed around the molecular composition of tumors and blood cancers. That’s why we’re engaging with Baptist and other providers to conduct interinstitutional tumor board consultations and launch similar collaborative initiatives.”
Philip Lammers, MD, MSCI, chief of Medical Oncology and the medical director of Oncology Clinical Research at Baptist Cancer Center, is also passionate about health care equity. He joined the Memphis-based hospital system in 2018 after serving as chief of the Division of Hematology/Oncology at Meharry Medical College.
“My work at Meharry was focused on trying to get patients from Nashville who were from minority and other diverse backgrounds to gain access to more clinical research,” Lammers said. “I’ve undertaken a similar mission here. We are one of only 14 minority and underserved NCORP grant sites around the country. What that means is the National Cancer Institute wants us to have at least 30% of our patients for clinical trials to be from minority and underserved groups. We’ve consistently enrolled around 35% of this population to our clinical trials in the last five years, which is much higher than national averages. We want to make sure that we conduct research in ways that minority and other underserved populations trust and want to participate in. In my experience, it is less about patients not wanting to participate. It’s about patients having barriers to participate.”
One of those clinical trial initiatives is funded by a grant from the Leukemia & Lymphoma Society with additional financial support from Baptist and Vanderbilt-Ingram. IMPACT (Influential Medicine Providing Access to Clinical Trials) will offer access to clinical trials at nine Baptist locations to patients living in nearly half of the counties and parishes in the Delta Regional Authority, one of the most economically vulnerable areas of the United States.
Michael Savona, MD, holder of the Beverly and George Rawlings Directorship, professor of Medicine, and chief of the Section of Hematology, Cellular Therapy and Stem Cell Transplantation, is leading the project.
“We are very proud to work with our colleagues at Baptist on IMPACT, a vanguard program, from which our grant was one of three chosen by the Leukemia & Lymphoma Society in 2021. Since then, we are engaged in the community and making real inroads offering clinical trials to patients who have never had these kinds of options,” Savona said.
Another initiative supported by a grant from the NCI is to evaluate use of telehealth for patient education and self-management skills with virtual access to the VICC molecular tumor board for newly diagnosed adult patients, together with telehealth survivorship care for those off therapy. Lammers is collaborating on this project with Debra Friedman, MD, MS, the E. Bronson Ingram Chair in Pediatric Oncology and associate director for Community Science and Health Outcomes at Vanderbilt-Ingram. Survivorship programs help patients adhere to their cancer treatment plans and then assist them in maintaining their health afterward with self-management guidance. The study sites include seven Baptist locations in the Deep South. Another Vanderbilt Health Affiliated Network site, Ballad Health Cancer Care, with locations in Appalachia, also participates in this project.
“Using telehealth and community outreach to bring precision oncology, patient support and survivorship care to underserved populations across our catchment area offers the opportunity to increase cancer health equity and access to comprehensive care, allowing patients to remain close to home for treatment. We are testing different delivery methodologies in a real-world setting to see what works best,” Friedman said.
Baptist and Vanderbilt physicians have jointly hosted community outreach programs for the public on topics including screenings for lung cancer and breast cancer research advances. They plan to do more of these engagement events for patients and are in the process of hiring a health educator for the catchment area served by Baptist to discuss clinical trials with patients and answer their questions.
The affiliation is multilayered and even includes work to improve collaborations on molecular testing, data sharing and building electronic health record software programs so that data can be readily shared. Physicians from Baptist consulted with physicians from Vanderbilt-Ingram in setting up a CAR T-cell therapy program, a relatively new treatment that reengineer’s patients’ immune systems to recognize and attack cancer cells.
Baptist benefits from the affiliation by being able to offer more clinical research opportunities for patients. Vanderbilt-Ingram benefits by expanding its clinical research, allowing testing of new approaches to care across diverse populations. The people of the region benefit from strategies to improve cancer outcomes.
Mississippi is a state where Lammers said there is a great need for action.
“The National Cancer Institute really recognizes our work in Mississippi as the largest player trying to bring patients into clinical trials,” he said. “That state has a lot of struggles with very high cancer incidence rates and mortality rates. That’s another big benefit of working with Vanderbilt — being able to offer cutting-edge clinical trials through their programs to those patients in Mississippi who otherwise may not have those options.”