Increasing Access to Clinical Trials

Name: Increasing Access to Clinical Trials
Uploaded: 2025-01-13T13:51:40.8Z
Duration: 29 min

January 13, 2025

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00:00Funding for Yale Cancer Answers
00:02is provided by Smilow Cancer
00:04Hospital.
00:06Welcome to Yale Cancer Answers
00:08with the director of
00:09Yale Cancer Center, Doctor Eric
00:11Winer.
00:12Yale Cancer Answers features conversations
00:14with oncologists and specialists who
00:16are on the forefront of
00:17the battle to fight cancer.
00:19This week, it's a conversation
00:20about clinical trials with doctor
00:22Ian Krop and Alyssa Gateman.
00:24Doctor Krop is a professor
00:25of internal medicine and medical
00:27oncology at the Yale School
00:28of Medicine, and Alyssa Gateman
00:30is the executive director of
00:32the clinical trials office at
00:33Yale Cancer Center. Here's
00:35doctor Winer.
00:38Let's just begin talking
00:39a little bit about each
00:41of you and how you
00:42got interested in this line
00:44of work.
00:45Alyssa, how'd you wind
00:47up working in clinical trials?
00:49Thank you, Eric.
00:51I fell into clinical trials
00:53about twenty five years ago.
00:56The first part of
00:57my career, I was working
00:59with investigators
01:00on studies that they developed
01:01themselves and really on the
01:03data side. But for the
01:04majority of my career, I
01:05have been working in quality
01:09and compliance, really ensuring that
01:11our patients that
01:14are participating in research studies
01:16are protected,
01:18that they have been provided informed
01:19consent, and that the data
01:21that they're providing
01:23to lead to new treatments
01:24is actually collected and credible data.
01:27A few years ago, as
01:28you know, I transitioned
01:30now over more to operations
01:31and administration.
01:34But one of the passions I
01:36have is really educating
01:38new clinical research professionals and
01:40making everyone aware
01:42as they're trying to go
01:44through their professions and look
01:46at what their career options
01:47are of the options of being
01:48a clinical research professional.
01:54An Ian, wha
01:54got you into this?
01:57You are also
01:59a clinician and a researcher.
02:04What made you interested in
02:05cancer, and what got you
02:08involved in clinical
02:10trials?
02:12Personally I didn't fall into clinical trials.
02:14I think I more gradually
02:15crawled into this area.
02:19I was originally
02:20a laboratory
02:21researcher trying to understand
02:24what causes cancer, what causes
02:26cancer to become resistant
02:29to our treatments.
02:31But over time, I
02:34wanted to more directly
02:38impact patients and have
02:40the research
02:42help patients directly rather than
02:45the gradual process of laboratory
02:46research. So I started doing
02:48more and more
02:50clinical trials, testing new drugs
02:51to help
02:52patients
02:53with breast cancer, and
02:55that just became
02:58such an exciting field.
03:01I couldn't leave it until
03:03it became my full time
03:04job, roughly twenty
03:05years ago and have
03:06continued to do that moving
03:08from Boston
03:10now here to Yale,
03:11two and a half years
03:12ago.
03:14Well, clinical trials are obviously
03:16very important
03:18because there is no scientific
03:20discovery that goes from
03:22some scientist's
03:23lab
03:24to the pharmacy
03:26shelf without a clinical trials
03:28component
03:29in between.
03:30With that said,
03:32what's involved for a patient
03:34in joining a clinical trial?
03:36It's a great question
03:39because it's not
03:41something that you necessarily are
03:43gonna know unless you've
03:45been involved.
03:47I don't think many of the
03:49medicine shows on TV really
03:51talk about
03:52clinical trials, so
03:54happy to explain.
03:57For most patients,
04:01getting involved in a clinical
04:02trial starts
04:03in their discussions
04:05with their healthcare provider about
04:08what treatments makes sense for
04:10them,
04:11as in the next step
04:15of their journey.
04:17And we
04:18really feel strongly that a
04:20clinical trial is part of the
04:25overall treatment options available to
04:28patients.
04:29And so when
04:30a patient is deciding
04:32on what treatment option to
04:34take,
04:35the providers
04:37provide that
04:38treatment, a clinical trial option,
04:40as well as what we
04:41call standard of care, the
04:42FDA approved
04:43options.
04:48If the trial is of interest
04:50to the patient,
04:51we then go into more
04:53detail about
04:54about
04:55what's involved with the trial.
04:58We go over what's called
04:59the informed consent document that
05:01Alyssa mentioned earlier, which is
05:03basically
05:05a very in-depth description of
05:07what's involved in the trial,
05:09both what procedures and steps
05:12and visits are required, but
05:13also most importantly the rationale
05:15for the and the
05:17potential benefits and the potential
05:19risks.
05:22After the patients read that
05:26and talk with their family
05:27and talk with their provider,
05:28if they decide they are
05:30wanting to participate in the
05:31trial, they would then sign
05:33the consent.
05:34Then we would as a team,
05:38make sure that the patient
05:40meets what's called the eligibility
05:41of the trial, which is
05:42all the
05:44criteria
05:45that the patients,
05:47who the physicians who design
05:49the trial,
05:50feel are important from
05:52both the question that's
05:54being answered as well as
05:55the safety for the patients
05:57that they need to meet
05:58those criteria to be eligible
06:00for the trial. If they
06:01are found to be eligible,
06:03then they go ahead and
06:06start the trial
06:08and continue on the trial
06:10as part of their
06:11treatment. So it's not
06:15oftentimes in addition to their
06:16treatment,
06:18that's going to be their
06:19treatment for the
06:20period of time that they're
06:21on the trial.
06:23Alyssa, maybe
06:24you can comment on this.
06:26It seems to me that
06:28people who have cancer
06:31are often in a vulnerable
06:33position.
06:34They are frightened.
06:36They sometimes, if newly diagnosed,
06:39are just overwhelmed
06:41by information.
06:43And making a decision about
06:45participating in a clinical trial
06:47can be tough, and
06:50you could also imagine
06:52that patients at times
06:55might feel pressured by
06:58someone, a family member,
07:01hopefully not a doctor,
07:03but someone to participate in
07:04the trial. How do we
07:05protect people from that sort
07:07of thing?
07:09Yeah. So I think, Eric,
07:11it is, as you said,
07:12a scary time a lot
07:14of times
07:15especially in oncology.
07:19There's a lot of information
07:20coming at them. I think
07:22we wanna make sure that
07:23our patients feel empowered to
07:25be able to ask questions
07:26of both of their providers,
07:28and, also, we have clinical
07:29trial office coordinators and nurses
07:32that are there for additional
07:34questions and logistics.
07:35But we also have
07:38patients whose rights are
07:39protected. So any clinical research
07:42trial
07:43that's ongoing, as Ian had
07:45mentioned, there's the informed consent.
07:47That informed consent is reviewed
07:49by what we call an
07:50institutional review board
07:52that reviews things for ethical
07:55reasons, but then also really
07:56make sure it
07:58accurately
07:59captures the information of that
08:01trial so they do have
08:02the information to take home.
08:04And it's really in the
08:06patient's rights to have that
08:07informed consent and all their
08:09questions answered.
08:10So it should be a
08:11process. It's not a, this
08:13is presented to you and they need a
08:14yes or no right away.
08:18You can take that back,
08:19take it to your
08:20family, friends, trusted
08:24folks to be able to
08:26get their questions answered and really
08:28be thoughtful
08:29as part of that process.
08:31Also, after joining in a
08:34clinical trial, if you agree
08:35to participate,
08:36it is in that
08:38patient rights to withdraw
08:40at any time,
08:41and to have that discussion.
08:43And that won't impact future
08:45decisions,
08:47with that ability to withdraw.
08:49You know, I often tell
08:50patients
08:52that the clinical trials
08:54that we have are not
08:55clinical trials that some doctor
08:58or other researcher
09:00dreamt up some night and
09:01then put on paper the
09:03next morning and offered to
09:04patients the next day, that
09:08these are
09:09ideas that have been developed
09:11and have been reviewed and
09:13reviewed and reviewed by multiple
09:16groups of people,
09:18sometimes on a national level,
09:20sometimes on a
09:22local level, but in all
09:24cases, they are very carefully
09:26vetted.
09:27What kind of review
09:29process
09:30goes on
09:32locally
09:33when we have a
09:34clinical trial?
09:36Yeah. So I think
09:37that's a very
09:38good point.
09:41It is quite a
09:42thorough vetting process. There are
09:45multiple committees,
09:46both
09:47committees made up of the
09:49experts of
09:52the cancer type that's
09:53being evaluated in the clinical
09:55trial,
09:57as well
09:58as experts in a number
10:00of other fields such as
10:01statistics and
10:05logistics of the trial to
10:06make sure it's feasible.
10:08And then you have, as
10:10Alyssa mentioned, the Institutional Review
10:13Board, which is looking more
10:14at the ethics of the
10:16study and making sure patients
10:17are fully educated about the
10:19trial.
10:20And that consists of both
10:22medical professionals,
10:23research professionals,
10:25and community
10:27representatives to fully
10:31have the perspective
10:33of our community involved in
10:35deciding whether a trial is
10:36appropriate to move forward.
10:38And all of those things are
10:38done both to protect the
10:40patient, but also to make
10:42sure that the trial is
10:43being done in a way
10:44that's
10:45optimally designed to be able
10:47to answer the question
10:49that's being asked, because
10:50we're asking patients
10:52to give up of their
10:53time
10:55to participate in the trial.
10:57Trials are very expensive.
10:58So there's a lot that
11:00is involved in the trial.
11:01And so we at the
11:02end, we really wanna make
11:03sure that we're definitively
11:05answering
11:06an important question to be
11:07able to
11:08help our patients moving forward
11:10and improve the treatment for
11:12the next
11:13generation of patients.
11:16Now
11:16we know that there are
11:18many different kinds of trials,
11:19and there are trials that
11:20go from being
11:22somewhat more investigational
11:24to somewhat
11:27more like standard treatment where
11:29we're just bearing one small
11:30component to try to see
11:32if we can make a
11:33treatment a little less toxic
11:36or a little bit more
11:37effective.
11:38So we often refer to
11:40these as phase one and
11:41phase two and phase three
11:42trials.
11:43Could you tell us a
11:44little bit about
11:45what each of those
11:48consists of?
11:50In a very
11:51concise way,
11:53the first trial
11:54is a phase one trial
11:56where we're initially looking at
11:58a drug for the first
11:58time in patients and that's
12:00purely just making sure that
12:02it's safe to give the
12:03drug and that we figure
12:04out what the right dose is.
12:06That's a small trial with
12:07generally maybe only twenty or
12:09thirty patients.
12:11And if I can
12:12just interrupt and to be
12:13clear, that's the endpoint of
12:15the trial, although when a
12:16doctor is treating a patient,
12:18it's with the hope that
12:19that drug will help someone.
12:21That is correct.
12:23And that is also looked
12:24at in the trial. But
12:25as you said, the
12:26primary purpose is to just
12:28establish the safety and the
12:30right dose.
12:31Nowadays, because our
12:32drugs are so
12:34sophisticated, as soon as they
12:35come out of the lab,
12:36oftentimes, we actually see, you
12:38know, a great deal of
12:40effectiveness in that even in
12:41that first trial.
12:43And in a phase two
12:44trial?
12:46So a phase two trial
12:47is a slightly larger trial
12:49where we're now really trying
12:50to focus on how effective
12:52that drug is,
12:53for that particular patient population.
12:56And then if it shows
12:57to be
12:59effective
13:00and promising, it then moves
13:01to a phase three trial
13:02where that trial drug is
13:04being compared
13:05to the current standard of
13:07care to see which one
13:08actually is more effective.
13:11Well, that is very helpful.
13:14We're gonna just take a
13:15very brief break, and we'll
13:17be back with our guests
13:19Alyssa Gateman and Ian Krop
13:21in just a minute.
13:23Funding for Yale Cancer Answers
13:25comes from Smilow Cancer Hospital,
13:27where the Lung Cancer Screening
13:29Program provides screening to those
13:30at risk for lung cancer
13:32and individualized
13:33state of the art evaluation
13:35of lung nodules.
13:36To learn more, visit smilowcancerhospital
13:39dot org.
13:41Over two hundred and thirty
13:43thousand Americans will be diagnosed
13:45with lung cancer this year,
13:46and in Connecticut alone, there
13:48will be over twenty seven
13:49hundred new cases.
13:51More than eighty five percent
13:52of lung cancer diagnoses are
13:54related to smoking,
13:56and quitting, even after decades
13:57of use can significantly reduce
13:59your risk of developing lung
14:01cancer.
14:02Each day, patients with lung
14:03cancer are surviving thanks to
14:05increased access to advanced therapies
14:07and specialized care.
14:09New treatment options and surgical
14:11techniques are giving lung cancer
14:12survivors more hope than they
14:14have ever had before.
14:15Clinical trials are currently underway
14:17at federally designated comprehensive cancer
14:20centers
14:21such as the battle two
14:22trial at Yale Cancer Center
14:24and Smilow Cancer Hospital,
14:26to learn if a drug
14:27or combination of drugs based
14:29on personal biomarkers
14:30can help to control non
14:32small cell lung cancer.
14:34More information is available at
14:35yale cancer center dot org.
14:37You're listening to Connecticut Public
14:39Radio.
14:40Good evening again. This is
14:42Eric Winer. I'm the director
14:44of Yale Cancer Center,
14:46and I'm here tonight on
14:49Yale Cancer Answers with my
14:50guests
14:51doctor Ian Krop
14:54who is the director of
14:55the clinical trials office, and
14:57Alyssa Gateman, the executive director
14:59of the clinical trials office.
15:02Alyssa, maybe I can start
15:03with you.
15:07Why is it important
15:09that
15:10we include a diverse group
15:12of people in clinical trials?
15:14I think there's been a
15:15tendency in years past
15:18for our clinical trials population
15:20to look a little homogeneous,
15:21and we're all worried about
15:23that. And we wanna make
15:24sure that that's something that
15:27that doesn't continue.
15:31So diversity
15:32and inclusion in our clinical
15:33trials is extremely important. At
15:36the end of the day,
15:37our clinical research
15:39is putting new products and
15:40new treatments out for the
15:43population. So what we're really
15:44looking for is
15:46generalizability
15:47of research results.
15:49If we have a homogeneous
15:51population,
15:52we only really get answers
15:53on that population on how
15:55it works. And there are
15:56differences. There's differences between genders.
15:59There's differences between ages. There's
16:01differences between racial and ethnic
16:03groups.
16:04So ensuring that the entire
16:06population that's going to be
16:08treated with that product potentially
16:10is included in those research
16:12studies,
16:13is really important so that
16:15we can understand all the
16:16different potential side effects and
16:18the different effectiveness
16:20for those patients that ultimately
16:22may be receiving those therapies.
16:25And
16:26we and others have pushed
16:27very hard to
16:29make sure that
16:31our clinical trials do include
16:33a diverse group of patients.
16:35And, of course, there have been
16:37research findings over the past
16:39couple of decades that have
16:41shown that
16:42many people who are from
16:44underrepresented backgrounds just don't get
16:46offered clinical trials as often
16:48as others, and so
16:50we really try to do
16:51that as do people around
16:53the country.
16:55I wanna move on to
16:56talk for a minute about
16:57myths about clinical trials.
17:03Ian,
17:04I'm sure you've had patients
17:06say to you over the
17:07years,
17:09doctor Krop,
17:10don't you just wanna
17:12use me as a guinea
17:14pig?
17:15And
17:16how do you answer that
17:18question?
17:22I think that's an important
17:24point to clarify
17:25because there is that myth
17:27out there.
17:28And I think as Alyssa very
17:35eloquently stated, how important it is for
17:42anybody on a trial
17:43that their rights are protected
17:45and that the safety
17:47of them is paramount
17:49and an enormous amount
17:50of work goes into making
17:52sure that is actually
17:53the case.
17:55But, you know,
17:57again, I think a
17:57clinical trial,
18:00particularly
18:02in this day and age,
18:04is the way to get
18:07access to the
18:09most cutting edge treatments,
18:13and I think
18:14those of us
18:17at Yale Cancer Center
18:18feel that a clinical trial
18:19is really part of
18:24top quality
18:27cancer care now,
18:29having access to clinical trials
18:31is really
18:32critical,
18:34for that.
18:36And getting back to
18:37your previous question about the
18:39need to make sure that
18:40we have a diverse population,
18:42I think not only do
18:43we need a diverse population
18:44in our clinical trials so
18:45that we can make sure
18:46that the results we get
18:47are applicable to all groups,
18:50I think it's also
18:52a disparities issue. I think
18:54if people don't have
18:56access to
18:57clinical trials,
18:59where they're being seen,
19:00they don't have access to
19:03to the optimal care.
19:04And I think that's
19:06another reason why
19:07at Yale Cancer Center we try to
19:09make sure we have access
19:10to clinical trials for our
19:11patients across all
19:13of our sites
19:15across Connecticut.
19:16And while there are obviously
19:19no guarantees
19:20when someone receives a standard
19:22treatment or
19:23when they're on a clinical
19:25trial, the
19:27hope when people
19:28develop clinical trials is that
19:30the treatment is actually going
19:32to be better in one
19:33way or another.
19:35We don't go into clinical
19:37trials
19:38intending
19:39to come up with a
19:40worse result, and it doesn't
19:42happen
19:43very often. Although, again, there
19:45can be no guarantees.
19:50Can you give us some
19:51examples
19:53of some of the breakthroughs
19:55we've seen in the last
19:56five to ten years,
19:58and,
20:00there are many
20:01that have come about as
20:03a result of clinical trials.
20:06Yeah. I would
20:07argue that essentially all of
20:09the breakthroughs that have happened
20:10in the last five or
20:12ten years
20:14are as a result of
20:15clinical trials. As you said
20:17in the introduction, a
20:19drug doesn't go from the
20:21laboratory
20:22to the pharmacy.
20:23It only gets to
20:25a place where patients can
20:27access it through clinical trials.
20:30And,
20:31you know,
20:33twenty years ago when I
20:34started in this field, or
20:35actually, now it's twenty five
20:37years ago,
20:38time flies,
20:40you know, we were
20:42in breast cancer, for example,
20:44in almost all cancers,
20:46the treatments available were essentially
20:48all chemotherapy.
20:50And chemotherapy can be effective
20:51in cancer, but
20:55it has a
20:57substantial risk of side effects
20:59in many patients because
21:00the chemotherapy
21:02isn't very good at distinguishing
21:04between
21:05the cancer itself
21:06and a patient's normal cells.
21:09It can definitely kill cancer
21:10cells but also can damage
21:12normal cells and that's where
21:13the side effects come from.
21:14And the revolution in cancer
21:16care in general has come
21:17about because
21:20we've
21:21changed our treatment paradigm in
21:23many, if not most cases,
21:26to drugs
21:27that target something that's specific
21:29within the cancer cell that's
21:31not
21:31present in the normal cell.
21:33So this so called targeted
21:35therapy, which is targeting what's
21:37specifically driving the cancer,
21:39tends to have substantially fewer
21:41side effects because
21:42it is more targeted directly,
21:44and specifically
21:45at the cancer cells.
21:47And so that's the major
21:49breakthrough
21:50that's happened over the last
21:51ten to twenty years And
21:53that's all come
21:54about both from tremendous laboratory
21:57research as well as all
21:58the clinical trials that have
22:00been
22:00required to translate those discoveries
22:03in the laboratory into
22:05actual
22:06drugs available for patients.
22:08Ssome of the
22:09big ones that have happened
22:11are
22:14immune therapies, which
22:16enable
22:17the patient's own immune system
22:19to rise up and attack
22:21the cancer, and that's revolutionized
22:23the care
22:24of many
22:25cancers, including melanoma and
22:29lung cancer and kidney cancer
22:30and essentially all cancers are
22:32now
22:33involved with using
22:35immunotherapy.
22:37And then we have a
22:37host of oral
22:39pills that target specific mutations
22:42within the cancer,
22:43that have
22:45had huge benefits in specific
22:47types of lung cancer, breast
22:49cancer,
22:50prostate cancer,
22:52and many others.
22:54And then one thing that
22:55I personally have been working
22:56on and now many of
22:58us are working on are
23:00a whole new class of
23:01drug which
23:02goes by
23:03the scientific name of an
23:05antibody drug conjugate. But essentially,
23:07it's
23:08a way to
23:10specifically deliver chemotherapy
23:12right to the cancer cell
23:14using new
23:15antibody technologies and that makes
23:18the chemotherapy much more like
23:19a guided missile or a
23:20smart bomb rather than
23:25a chemical that just goes
23:26everywhere and damages both normal
23:28tissue and cancer. So all
23:30of these
23:32whole classes of drugs are
23:33new
23:35and
23:36only are possible and are
23:37only available to patients because
23:39of
23:40all of the patients that
23:42have, you know, courageously
23:44elected
23:45to go on to clinical
23:47trials
23:48over the last twenty years,
23:49to demonstrate how
23:51much of
23:52a breakthrough all of these
23:53drugs were, and they're now
23:55standard of care.
23:57It's remarkable.
24:00Alyssa,
24:01is it more work for
24:02somebody to be on a
24:03clinical trial?
24:05Does it require more
24:07visits to the clinic? Does
24:09it require
24:11added expense,
24:13added time from family members?
24:16That's a great question, Eric.
24:18And I think sometimes, yes.
24:20The answer is yes. However,
24:22I think the
24:25access to trials
24:27is important as far as
24:29there's also more oversight.
24:32So the fact that
24:34a patient
24:36is very closely tracked
24:39in research studies. There are
24:40some studies that may require
24:42a few additional visits. I
24:43think we talked about earlier
24:45the different phases of trials,
24:48and some trials do have
24:50more requirements, especially
24:52when they're being tested for
24:53safety. So there may be
24:55more visits required to ensure
24:57the safety of those
24:58patients that are participating.
25:01For expenses,
25:03there are really two types
25:05of costs associated with clinical
25:06trials. There's routine medical costs.
25:09Those are no different than
25:10the standard of care.
25:12And then, typically, research costs
25:14are covered
25:17by the sponsor, by the
25:18industry, by the funder,
25:20whoever is supporting that clinical
25:22trial.
25:23We also try to offset
25:25through
25:26stipends or reimbursements
25:28as much as we can
25:29for additional
25:30transportation or additional needs that
25:32might to be able to
25:34provide the access to
25:36our patients to those trials.
25:39Some trials do require more
25:41than standard of care. Some
25:42are actually in line with
25:44the standard of care
25:45visits and would
25:47not require much more time
25:48and effort.
25:50And I would just
25:51add that, you know, while
25:53there may be some additional
25:54visits involved in a clinical
25:55trial in some situations,
25:57there's also more team members
25:59involved in doing the
26:00monitoring that Alyssa was mentioning.
26:03So when a patient's on
26:04a trial, they have a
26:05bigger care team
26:08available to them,
26:09more nurses
26:11and research coordinators who can
26:13provide assistance and answer questions
26:15and be more available
26:17quickly if a patient has
26:18questions. So it's kind of
26:20an added benefit to being
26:22on a trial is that there's
26:24this bigger team around to
26:26support the patient,
26:28while they're on the study.
26:30So as we begin to
26:32wind up, I'm gonna ask
26:33one more question,
26:35which is,
26:38imagine
26:39you're doing a phase three
26:42trial, so this is a
26:43randomized trial comparing two different
26:45treatments.
26:47And at some point in
26:49time, because these trials are
26:51monitored carefully,
26:53it becomes clear
26:55that one treatment is better
26:57than the other.
26:58How was the decision made
27:00to make that information available
27:02to patients and potentially to
27:04provide that new treatment to
27:06patients?
27:09So each trial
27:13has
27:14what's called a data safety
27:15monitoring
27:16committee. So a group of
27:18independent,
27:20physicians and statisticians
27:22who follow
27:23the course of the trial,
27:25very closely
27:27as it goes on in a phase
27:29III trial like you're mentioning
27:31can go on for multiple
27:32years.
27:33And this
27:35committee
27:36looks at those kinds of
27:37results that you're talking about
27:39on a regular continuous basis.
27:42And if they see
27:44a clear winner
27:45in a trial like that,
27:47they have the authority to
27:48stop the trial at that
27:50point.
27:51And
27:52depending on the situation, if
27:53they feel like it's in
27:54the best interests
27:55of the participants,
27:58can then
27:59allow the patients who were
28:01on
28:02the
28:03standard drug
28:04that
28:05turned out not to be
28:08the best one, that the
28:09newer drug was clearly better,
28:11they have the authority to
28:14mandate that the patients who
28:15who were not receiving
28:17the newer drug can then
28:18switch over, we call crossover,
28:20to the newer drug
28:22to get access
28:23to that
28:24superior therapy right away rather
28:26than have to wait for
28:27the drug to get approved
28:28by the FDA.
28:30Doctor Ian Krop is a
28:32professor of internal medicine and
28:33medical oncology at the Yale
28:35School of Medicine, and Alyssa
28:36Gateman is the executive director
28:38of the clinical trials office
28:40at Yale Cancer Center.
28:41If you have questions, the
28:43address is canceranswers
28:44answers at yale dot e
28:45d u, and past editions
28:47of the program are available
28:48in audio and written form
28:49at yale cancer center dot
28:51org. We hope you'll join
28:52us next time to learn
28:53more about the fight against
28:55cancer. Funding for Yale Cancer
28:57Answers is provided by Smilow
28:58Cancer Hospital.