Impact of a standardized prescreening intervention on clinical trial access and minority enrollment in breast cancer trials.

135 Background: There remains an underrepresentation of racial and ethnic minorities in breast cancer clinical trials, particularly among Black and Hispanic patients. This disparity limits the generalizability of outcomes and the equitable distribution of novel treatments. Strategies that expand access and increase the representation of minority patients in trials are crucial for advancing health equity. Prescreening is a quick initial assessment of a patient's trial eligibility before complete screening and consent, a process that is often informal and inconsistent. We evaluated the impact of a standardized prescreening process on clinical trial enrollment, particularly minority patient enrollment, within a single breast oncologist’s panel in a larger multi-physician practice. Methods: In 2024, the clinic team (nurse/physician) implemented a standardized pre-screening process that involved bi-weekly meetings with the research team to review two weeks of upcoming patient visits. The clinic team reviewed each patient’s chart to identify potential trial candidates, prompting the research team to investigate trial eligibility criteria further. Eligible patients were flagged with a chart alert in the electronic medical record. The chart alert prompted the physician to discuss appropriate clinical trials with the patient during their visit, after which the research team obtained consent. We compared total enrollment and minority enrollment pre-implementation (2023) and post-implementation (2024). Results: In 2023, 743 breast cancer patients were seen, of which 13 (1.75%) enrolled in a clinical trial. Four patients identified as racial/ethnic minorities (2 Black, 2 Hispanic). In 2024, 781 patients were seen, of whom 50 (6.4%) were enrolled in a clinical trial, resulting in a 4.65 percentage point increase in enrollment rate. Minority enrollment increased from 4 to 22 patients, resulting in a 5.5-fold rise in minority representation, comprising 12 Black and 5 Hispanic patients. Conclusions: Implementation of a nurse/physician-led standardized prescreening process, involving frequent and close collaboration with the research team, improved clinical trial access and enrollment, including greater representation of minority patients. This approach is a viable strategy for advancing equity in clinical trials. Enrollment outcomes before and after implementation of a standardized pre-screening process. Enrollment Category 2023 2024 Total clinic patients 743 781 Total patients enrolled 13 50 % Patients enrolled 1.75% 6.40% Total minority patients enrolled 4 22 % Minority patients enrolled 30.77% 44% Total Black patients enrolled 2 12 % Black patients enrolled 15% 24% Total Hispanic patients enrolled 2 5 % Hispanic patients enrolled 15% 10%