Advanced practice providers are collaborating on system-wide efforts to elevate the role of oncology APPs in NCI-sponsored research

Oncology advanced practice providers (APPs) are highly trained health care providers who contribute substantially to quality cancer care. While the number of oncology APPs has grown significantly over the last decade, their role in clinical research has not followed suit.

In response, representatives from the National Clinical Trials Network (NTCN), the NCI Community Oncology Research Program (NCORP) Research Bases, and the National Cancer Institute formed the APP Working Group. ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) Vice Chair Al Benson, MD, and Oncology Nursing Committee Chair Bridget O’Brien Fagan, DNP, APN, FNP-BC, AOCNP, were among those sharing highlights of the working group’s efforts at a featured session during the ECOG-ACRIN Group Meeting in October.

Established in the fall of 2021, the APP Working Group has led several initiatives, including a spring 2022 APP Symposium to discuss the role of APPs in NCI-sponsored clinical trials, an APP Clinical Research Workshop held in October 2022 (training available here on the SWOG website), and at the 2023 NCORP Annual Meeting that included awards to the highest accruing non-physician investigators.

A 2020 survey of more than 400 oncology APPs found that 90% of respondents felt that APPs should play a greater role in clinical research, and 73% would like to be more involved. Barriers to APP research participation include insufficient clinic time, policies that limit APP participation, and a need for clinical trial–related education. Elevating the role of APPs as partners in the clinic will help to reinforce the important role clinical trials play in cancer care and strengthen accrual efforts. Often, patients are not offered a clinical trial during discussions of treatment options, and APPs have the potential to enhance these discussions with patients, making sure patients are aware of all options.

ECOG-ACRIN is providing the support for creation of an APP Clinical Research Manual—a keystone effort of the working group. This manual is currently being drafted and will be made widely available to provide education and guidance for oncology APPs and their centers. Topics covered include the types, phases, and endpoints of clinical trials; research team roles and responsibilities; the protocol development review process; regulatory affairs and data management; enrollment and informed consent processes; auditing and monitoring; the NCI Cancer Therapy Evaluation Program’s APP prescribing policy; and tips for discussing trials with potential participants.

All of these efforts (with more to come) are aimed at encouraging and enabling health care leaders to establish APP programs at their institutions and create more opportunities for advanced practitioners to play a greater—and much-needed—role in oncology clinical research.

Update November 1, 2024: ECOG-ACRIN is now classifying this group as the Advanced Practice Provider (APP) Committee.