It really is a two-way street. They may send us some patients whose treatments, including specialized tests, may only be done at Stanford. Sometimes the FDA or a company will mandate that a phase I trial may only be done at one center because of unique risks and the need for uniform observation and follow-up. On the other hand there are other trials that can be done in the community that may be initiated at Stanford or centered at Stanford, but where we share protocols with our affiliates. The pattern that we've seen is that patients will come here for their trial and then return home to see their oncologists and family physicians.
Patients tend to want to be treated locally.
And we're willing to train their personnel as well to make sure that they are ready to do the trial at their site. The affiliates program involves the networking of knowledge and the ability to facilitate patient care - including transfer to Stanford for appropriate referral services. I think the trials office is a useful focal point for our affiliates, as well as a central place for us as researchers to come to. That brings up an interesting point. It's always a double-edged sword.