Clinical Trials Program at Metropolitan Nashville General Hospital

The Clinical Trials Core has been active since the initiation of the U54 and has systematically and progressively advanced by sustaining, improving and extending its basic mission despite facing significant challenges over the past few years. The Core accomplishes its goals by: 1) targeting minority and underserved patients for accrual on cancer clinical trials, 2) educating hematology/oncology fellows and 3) advancing research into the issues of the minority and underserved patient with cancer. Overall, the Core has entered large numbers of minority and underserved patients onto clinical trials and given these patients opportunities that are usually not available at community public hospitals.

Over the history of the Core, we have accrued 922 patients to clinical trials of which approximately 50% have been minorities.  The Clinical Trials Core is not limited in the type of trials that can be offered to patients.  Currently, we offer treatment-related clinical trials, cancer control research studies, diagnostic testing clinical research, hereditary cancer research, tissue specimen biobanking, and survey studies.  In step with the movement towards personalized medicine in oncology, the Clinical Trials Core is well positioned to participate in cutting-edge clinical research. In fact, MMC was one of the first 20 sites in the country to open the groundbreaking NCI-MATCH trial and enrolled a patient only two weeks after opening the trial.

Each week, the entire clinical trials team including clinical trials research staff, clinical staff, pharmacy, administrative personnel and physicians meet to discuss the diagnostic work-up and treatment options for each new patient diagnosed with cancer. A key member of this team is the cancer nurse navigator who meets with and assesses the needs of each newly diagnosed patient. The nurse navigator meets weekly with the research team to provide information on the socioeconomic resources of the patient. The nurse navigator is aware of potential clinical trials that the patients may participate in and facilitates the timely completion of all needed diagnostic tests. The nurse navigator is trained to provide clinical trials education, answer questions about clinical trial participation, and assist patients and their family members throughout their cancer care.

In 2014, MMC was successful in partnering with the Baptist Health System in Memphis, TN and awarded one of six national Minority-Based NCORP grants.  The overarching goal of the minority-based NCORP sites is to increase clinical trial opportunities and accruals for minority and rural populations.  As part of the NCORP mechanism, MMC is given access to the Cancer Trials Support Unit (CTSU) and can offer patients enrollment in trials of the major cooperative oncology groups such as ECOG, SWOG, and the Alliance for Clinical Trials in Oncology.

Another goal of the Clinical Trials Core is to train Vanderbilt University Hematology/Oncology Clinical Fellows in clinical trial experience at a minority and underserved setting.  Each clinical fellow spends time with the Core to learn aspects of clinical research which an emphasis on the unique research concerns  specific to the minority or medically underserved population.  Several fellows have had in-depth experiences with the core and have gone on to have impressive careers in the Oncology community (Table 1).

Clinical Fellows
Name Race Year Where are they now?
Vipul Patel    other  2006 Private practice in Charlotte, NC
Velmalia Matthews-Smith   African-American  2009-  2010  Has worked as a collaborator with MMC as  an oncologist with the Baptist Mid-South  NCORP at a sub-component site and continues to serve her community.
Olalekan Oluwole   African-American  2009-  2010  Assistant Professor ofMedicine, Vanderbilt  University School of Medicine, Division of  Hematology/Oncology
Sheldon Holder   African-American  2009-  2010  Assistant Professor,Institution College of  Medicine Department Medicine, Penn State  Hershey Cancer Institute
Rita Paschal  African-American  2009-  2012  Assistant Professor of Medicine,University of Alabama-Birmingham, Division of  Hematology/Oncology
Jeremy McDuffie    African-  American  2010-  2013  Private practice with Tennessee Oncology in  Murfreesboro, TN
Laila Agarwal   Asian  Caucasian 2013-  2016  Private practice at the Norton Cancer Institute in Louisville, KY
Graham Watson  Caucasian  2014-  2017   Private practice in Richmond, VA