Leveraging clinical and cultural insights to address barriers to global patient care and access to clinical trials
I collaborate closely with multidisciplinary teams and use qualitative and quantitative methods to examine the barriers preventing patients and their families from seeking the necessary treatment within their local contexts. These barriers range from stigma rooted in a patient’s culture to limited access to treatment and availability and access to clinical trials. By gaining an understanding of the scope of such issues, my colleagues and I can develop culturally sensitive interventions to mitigate such barriers and improve access to patient care and clinical trials.
I am very interested in understanding factors that affect a person’s decision to participate in clinical trials. Through our affiliate programs, I have worked closely with Dr. Carolyn Russo and Dr. Dylan Graetz to design a study in which parents of patients share their reasonings as to why they may or may not choose to participate in clinical trials. This work was inspired by a previous study I completed with Dr. Russo, which examined such barriers to participation from physicians’ perspectives. Such studies can help remove barriers and increase access to clinical trials, which will, in turn, help our patients and improve our understanding of cancers and other catastrophic diseases. Furthermore, in collaboration with Dr. Jennifer Mack at the Dana Farber Cancer Institute, we are conducting a study to understand clinical trial disparities in this underserved patient population to better address these needs in adolescents and young adults.
Another focus is my interest in understanding stigma as a factor in health disparities. Stigma is an underappreciated component when treating cancer and other catastrophic pediatric diseases, which may result in psychological and interpersonal issues for patients, depending on their local context.
As a clinical researcher for St. Jude Global, I am highly invested in understanding the role stigma plays in a patient’s diagnosis and subsequent care.
In collaboration with Dr. Graetz, I am exploring how stigma, especially in pediatric patients with retinoblastoma and osteosarcoma, is perceived by the patient, their family and the health care system in which they seek treatment. Our research examines stigma in the contexts of three culturally distinct countries — Guatemala, Jordan and Zimbabwe — so that we may understand the scope of the problem. This data will allow us to develop tools to better measure and quantify stigma and develop interventions to mitigate its role in a given culture’s health care systems.
In addition to my work addressing stigma and barriers to clinical trials, I am also invested in the bidirectional influence that implementation science has when working with our global alliance partners. Through the Blinatumomab Humanitarian Access Program (BHAP), co-led by Dr. Caitlyn Duffy, countries without access to this drug, which treats acute lymphocytic leukemia (ALL), can petition to receive it for free. My colleagues and I then collaborate with these sites to adapt the drug to their local context through training physicians, nurses and pharmacists, gathering performance data, and learning how it can be used most effectively in resource-limited settings. Not only do programs, such as BHAP, create opportunities for our global partners to offer their patients effective care, but the data gathered also informs how we approach designing trials and administering therapies in our own context at St. Jude.
Dr. Victor M. Santana is a Member of the St. Jude Faculty and the Charles B. Pratt Chair in Solid Tumor Research. He has been a part of St. Jude Children’s Research Hospital for 39 years and has served the institution in various capacities, including as a clinician, research investigator conducting clinical trials and working within the hospital and Cancer Center administration. He believes this varied background has given him a solid foundation to assist the global alliance partners in building infrastructure at their own sites. When he is not in the clinic or collaborating with global partners, he devotes time to developing ways to improve diversity within the Cancer Center and building and refining the Clinical Investigations Master's degree program within the St. Jude Children’s Research Hospital Graduate School of Biomedical Sciences
Victor M. Santana, MD
Charles B. Pratt Chair in Solid Tumor Research
Member, St. Jude Faculty
Department of Global Pediatric Medicine
MS 721, Room S2040