**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Vaishali Sanchorawala
Amyloidosis Center, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA

**Main Body of the Abstract**
Clinical trials (CTs) have helped pave the way for treatment of AL amyloidosis over the years. Despite notable progress, challenges persist in research, with regard to patient enrollment. This abstract outlines the portfolio of AL amyloidosis CTs at our center during the past three decades and identifies recent impediments to recruitment.
Between 1994 and 2023, a total of 632 participants with AL amyloidosis were enrolled in CTs at the center. There were 12 CTs of stem cell transplantation (SCT) with 341 participants and 24 CTs of non-SCT therapies with 291 participants. The majority of SCT-CTs were investigator-initiated trials (IIT; n=11); only one was a cooperative group conducted trial. Meanwhile, 10 of the 24 non-SCT-CTs were industry sponsored; 8 were IIT; 4 were multicenter IIT; and 2 were cooperative group conducted trials. Representation of racial/ethnic minorities in all trials was 11% (n=70), including 38 (6%) participants who self-identified as Non-Hispanic Black and 19 (3%) as Hispanic.
Over the last 5 years (2018‒2023), 130 patients were prescreened for 9 non-SCT treatment CTs, of whom 79 (61%) failed recruitment (Table 1). The most common reasons affecting enrollment were: patient preference due to trial protocol logistics (27%); dFLC not meeting eligibility (18%); cardiac biomarkers out of range (16%); and failure to meet other CT inclusion criteria (20%).
In conclusion, many participants have successfully enrolled in numerous CTs at our center, despite AL amyloidosis being a rare disease. Minority accrual was low. Both patient-related and protocol-related (i.e., restrictive inclusion criteria) factors frequently impeded CT participation.



Defying The Odds: A 30-Year Journey Through AL Amyloidosis Research With A Focus On Recent Structural/Clinical Barriers To Clinical Trial Enrollment PA154 (#212)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.