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This month, JOP highlights three of the 2005 Clinical Trials Participation Award winners: the Leo Jenkins Cancer Center at the Brody School of Medicine at East Carolina University, Greenville, North Carolina; Our Lady of Mercy Cancer Center, Bronx, New York; and Niagara Health Systems, in St. Catharine's, Ontario, Canada.
Twelve oncology practices were recognized with ASCO's Clinical Trials Participation Awards in 2005. The awards were established 3 years ago to underscore ASCO's commitment to promoting clinical cancer research. Selection for the awards was based on nomination by each of the National Cancer Institute cooperative groups and the ASCO Clinical Practice Committee, which identified the practices with the highest rates of accrual to phase III clinical trials over a 3-year period. In 2005, the awards were presented to practices that also had a high rate of accrual of under-represented minorities.
The Leo Jenkins Cancer Center provides tertiary care for an area with a population of 2 to 3 million people, many of whom are indigent. The center is at the Brody School of Medicine at East Carolina University, and according to Howard D. Homesley, MD, director of the Center's Division of Gynecologic Oncology, the entire surrounding area could be called “underserved.” That has not deterred Homesley from providing all patients the opportunity to participate in clinical research protocols.
“We bring Gynecologic Oncology Group [GOG] protocols to this population, with the goal that every protocol-eligible patient will actually be placed on one,” said Homesley. “These people receive the idealized care that goes along with protocol participation, including the structured management, the minimization of toxicity, and maximization of outcomes.”
Homesley has a long personal history of entering patients onto trials. He has served as chair of multiple GOG committees and study chair for various GOG protocols treating gynecologic cancers. “During my career, I've probably placed nearly 3,000 patients on GOG protocols,” he said. “Our current goal at the Leo Jenkins Cancer Center is to be among the highest contributors to the GOG Clinical Research Program, and already this year we've had over 70 entries.”
The Leo Jenkins Center evaluates approximately 300 new oncology patients each year, and is expanding both its clinical and basic science programs in many areas. Along with GOG protocols, the center now has Radiation Therapy Oncology Group (RTOG) and Eastern Cooperative Oncology Group (ECOG) protocols.
“The strategy is the same: to bring current or even cutting edge clinical research to this area, and give these people the best available care,” Homesley concluded.
Lady of Mercy Cancer Center is part of New York Medical College in the Bronx, but its practice is by no means limited to that borough. According to Center Director Peter H. Wiernik, MD, it attracts patients from a tristate area and beyond, and occasionally even from overseas. The reason is the center's breadth and depth. It is particularly known for its work in leukemia, lymphoma, melanoma, and kidney cancer.
“We're in the community, but we also do laboratory and clinical research,” said Wiernik. Along with his work as director, Wiernik is professor of medicine and radiation oncology at New York Medical College.
Several years ago, the National Cancer Institute recognized Our Lady Of Mercy Cancer Center with a minority-based Community Clinical Oncology Program (CCOP) award. According to Wiernik, that award acknowledges many factors.
“I think we've demonstrated that not only can CCOPs enter patients on study, but that CCOPs can have a major academic and intellectual role in cooperative groups, by writing protocols and papers and coming up with ideas for new studies,” said Wiernik. “It's not just a matter of contributing to other people's work.”
Our Lady of Mercy enrolls about 150 patients annually onto clinical trials, and more than half of those patients are minorities. “In total, about 12% of all the patients we see go onto study,” said Wiernik, noting that the national average is between 4% and 5%. “In addition, we operate the ECOG leukemia tissue bank and the ECOG immunoreference laboratory for leukemia studies.”
“You can do in the community what's being done at the larger centers,” said Wiernik, “but it's harder, because the larger centers always get the major support. However, providing what we provide to the community fulfills the promise of translational research.”
Canada's government-funded health care provides care for all citizens without charge, and at the Niagara Health Systems hospital, four medical oncologists provide care to a total population of about 400,000 people. “We stay busy,” said Brian P. Findlay, MD, chief medical oncologist.
Formerly at the Hotel Dieu Hospital, the Oncology Service in Niagara is well known for its record of accruing patients onto clinical trials, and for putting more patients on studies than many larger academic centers. Findlay started the trials program at Niagara Health Systems when he arrived 20 years ago. He has been study chair for two trials run through the hospital's cooperative group, the National Cancer Institute of Canada. Most of the patients currently on trials came through this group.
“We have always been committed to clinical trials,” Findlay said. “They bring state-of-the-art treatment to our patients, sometimes not otherwise available. They lead to significant improvements in survival and quality of life for cancer patients,” he concluded.