1. Webinar Instructions There will be a question answer session at the END of the webinar. During the presentation please use the Text Chat found on your Toolbar to type your question to the Presenter. Each question will be answered in the order it was received.

2. Recruitment of Mexican American Women with Breast Cancer to Clinical Trials in a Community Practice Setting Gary W. Unzeitig, M.D., F.A.C.S. Laredo, Texas

3. Why clinical trials? A means to stay on the cutting edge academically Provide community access to services that patients would otherwise have to travel great distances to receive Acknowledgement as a regional expert in my field

4. Clinical research in the community Most patients are cared for in the community Provides potential access to new therapies locally Provides a “real world” patient population and setting for studying new therapies Helps physicians keep current with standards of care and familiar with emerging approaches to treatment

5. Barriers in the community Economic Infrastructure Hospital engagement Physician engagement Patient concerns Trial complexity

6. 6 Ways to Minimize financial barriers “Buy in” from the hospital, clinic, or practice Contracts Efficient management Become better at what you do; the more you do, the better you’ll get Recognize what your site does well and what it cannot do Better trials/ better menus

7. Keys to Success Hospital/practitioner cooperation Community supportCommunity support Efficient infrastructure Personal commitment Good trial menu

8. Founded in 1755 by Don Tomás Sanchez Population: 217,000 Population of Nuevo Laredo, Mexico: 500,000 Laredo

9. Demographics Laredo US Median age 26 35.3 Median income $34,958 $60,374 % Hispanic 94.5% 15.1%

10. Trial Menu 15 open clinical trials, 10 breast cancer 95% enrollment/acceptance of eligible patients offered enrollment 2009 ASCO Clinical Trials Participation Award 2009 ACOSOG top accruing site

11. Laredo Culture Mexican culture –Family –Inherent trust in their doctor –Religion –Sense of community The comadre hotline….

12. Community awareness Regular interviews with patients on clinical trials on both English and Spanish TV stations and newspapers Community programs on different common cancers always include saludos (praise and thanks) for the patients who have participated in trials Phone calls always follow any public discussion of clinical trials from patients asking why they weren’t offered enrollment

13. Screening and enrollment Most common breast clinic patient referrals –Palpable lump or abnormal imaging Possible clinical trail eligibility and benefits discussed at initial meeting – pre-diagnosis Once eligibility confirmed, trial is discussed in detail with scheduled f/u visit to answer questions with patient and family members All consenting/trial discussion is done by MD

14. And for Laredo cancer care? Patients benefit by access to better treatment options Patients want to contribute towards improving cancer care Doctor’s Hospital has become the provider of choice for cancer care in the community Personally, I feel that I am making a difference for the better in the care of my patients and toward future cancer care.

15. Maria F Gonzalez TailoRx Maria B. Medina ACOSOG 1031 Oralia Martinez CALGB 40101 Annette Olsen-Fazi, PhD NSABP-B40 Idalia Treviño ACOSOG 0011 Diana Hamblin ACOSOG 1031