Ride to Care - A Pilot Study to Investigate the Clinical and Quality of Life Benefit of Eliminating Transportation Barriers for Disadvantaged Cancer Patients Undergoing Ambulatory Palliative Radiotherapy

PRIMARY OBJECTIVES:

I. To test whether eliminating transportation barriers for disadvantaged cancer patients can
reduce the 6-month rate of unplanned emergency department (ED) visits.

SECONDARY OBJECTIVES:

I. To test whether eliminating transportation barriers for disadvantaged cancer patients for
the duration of a palliative radiotherapy course will improve prescribed treatment completion
rates and reduce treatment delays and overall time to treatment completion.

II. To test whether eliminating transportation barriers for disadvantaged cancer patients for
the duration of a palliative radiotherapy course will have an impact on physician choice for
therapeutic modality, (3-dimensional conformal radiation therapy [3D CRT] versus
intensity-modulated radiation therapy [IMRT] versus stereotactic body radiation therapy
[SBRT]) and the fractionation schedules to minimize patient inconvenience.

III. To test whether eliminating transportation barriers for disadvantaged cancer patients
for the duration of a palliative radiotherapy course can reduce the short-term (6- months)
rate of grade >= 3 radiation related adverse events as measured by the Common Terminology
Criteria for Adverse Events (CTCAE) version 5.

IV. To test whether eliminating transportation barriers for disadvantaged cancer patients for
the duration of a palliative radiotherapy course can improve the patient?s experience,
functional outcome, and overall quality of life as measured by the European Organization for
Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]30.

V. To test whether eliminating transportation barriers for disadvantaged cancer patients for
the duration of a palliative radiotherapy course can reduce re-treatment rates, improve the
progression free survival rates, and overall survival.

VI. To determine if living within San Francisco County versus the surrounding counties
(Alameda, Contra Costa, Marin, San Mateo) within the San Francisco Bay Area has an impact on
outcomes.

OUTLINE:

Patients receive Uber rides to and from scheduled radiotherapy appointments for up to 6
months.

After completion of study, patients are followed up every 3 months for up to 3 years.

Inclusion Criteria:

- Written informed consent (and assent when applicable) obtained from patient or
patient?s legal representative and ability for patient to comply with the requirements
of the study

- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

- Histologically confirmed locally advanced or metastatic cancer

- Patients who have received prior courses of radiotherapy are eligible

- If patient answers yes to >= 2/4 of the questions below:

- In the last six months, have you ever had to go without health care because you
didn?t have a way to get there?

- Do you put off or neglect going to the doctor because of distance or
transportation?

- Does lack of money for transportation expenses (parking, taxi, bus) make it
difficult to get to the doctor?

- Would it be difficult to find a friend or relative to take you to a doctor?s
appointment, if you could not drive/transport yourself?

Exclusion Criteria:

- Pregnant, breastfeeding, or unwilling to practice birth control during participation
in the study

- Presence of a condition or abnormality that in the opinion of the Investigator would
compromise the safety of the patient or the quality of the data

- Patients who are living at a facility such as a nursing home or skilled nursing
facility

- Patients who do not live within a 30-mile radius of one of the radiation oncology
sites at University of California San Francisco (UCSF)

- Patients who are currently receiving or expected to be receive UCSF affiliated
transportation services prior to enrollment onto the study

- Patients who are wheel-chair bound or require special assistance in order to under
radiation treatment ineligible