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Pilot project to bring access to cancer clinical trial care closer to home for patients in northwest B.C.

Dr. Rob Olson stands in front of a linear accelerator at the BC Cancer – Prince George centre; the machine is used to deliver SABR treatment to clinical trial patients.

Cancer patients in northwest B.C. undergoing a high-precision radiation treatment (known as SABR), as part of a Prince George-based clinical trial, may have the opportunity to participate in a new pilot project that would bring access to care closer to home. The project is part of an international clinical trial led by Dr. Rob Olson with BC Cancer and the UBC Northern Medical Program (NMP).

Dr. Olson is currently heading a phase III clinical trial titled SABR-COMET-3, which is investigating whether the application of SABR to sites of cancer spread can improve survival and potentially cure some patients. SABR is a form of high-precision cancer therapy that delivers substantially higher doses of radiation to the tumour site in just one or a few treatment sessions.

In addition to B.C., the trial is also underway in Ontario, Australia, Scotland, and Ireland. The northwest of B.C. will be the first region within the trial to pilot partnering with community doctors and local health authorities to perform research follow-up with patient participants at hospitals closer to home.

“I have been advocating to improve access to clinical trials for northern, rural, remote, and Indigenous communities since I was recruited to the North in 2010, and I believe increasing access will lead to better treatment options and outcomes for northern patients,“ says Dr. Olson, UBC Northern Medical Program associate professor; division head, Radiation Oncology, Department of Surgery, UBC Faculty of Medicine; and radiation oncologist and department head at BC Cancer – Prince George. “We have a dynamic team in Terrace which includes Dr. Jaco Fourie, Dr. Jo Collins, and Dr. Denise Jaworsky. They will be completing clinical trial training, which will enable them to participate in patient trial follow-up visits, perform trial specific physical examinations, and record and report benefits and potential adverse events from the SABR treatments.

“We hope to demonstrate that it is feasible to partner with local physicians to remotely care for patients participating in clinical trials and accurately record and manage their potential side effects.”

Patients from non-urban and rural areas participating in BC Cancer clinical trials often have to travel long distances to their closest regional cancer centre to have follow-up physical examinations and medical history and side effects accurately recorded. This pilot project will enable various patients in Terrace and surrounding communities such as Hazelton, Kitimat, Prince Rupert, and Smithers to connect with physicians closer to home instead of travelling to BC Cancer – Prince George for follow-up.

“Instead of always travelling for trial follow-up with a specialist, patients will be able to see a local Terrace physician with oncology training who will provide care and also perform physical exams to document toxicity and benefits from the SABR treatment,” says Dr. Jaco Fourie, Northern Health Cancer Care Medical Lead and GPO (general practitioner in oncology), “while the oncologist will remotely consult over phone or video link.”

Patients are currently being accrued to the SABR-COMET-3 clinical trial from across B.C. and the international sites. Dr. Olson and the Terrace team are in the planning phases of this northwest pilot project, which includes signing up to the trial study team and partnering with Northern Health (NH) to develop the necessary protocols and documentation. Dr. Julia Bickford, NH Regional Director of research evaluation and analytics, will be helping to build clinical trial infrastructure including the set-up of training for NH members of the team.

“We’re hoping that this changes the future of clinical trials in B.C. and elsewhere,” notes Olson. “It will allow patients to participate in trials they would have previously declined because of the cost and inconvenience of travel. In many circumstances, the treatment intervention being investigated, such as chemotherapy or SABR, is only available to patients on trial and I strongly believe that all patients across B.C. should have equal access to clinical trials as a component of their care.”

The SABR-COMET-3 trial, and the northwest pilot project, is supported through funding from the Canadian Institutes of Health Research, Varian Medical Systems, the BC Cancer Foundation, Rio Tinto (in conjunction with the Prince George Community Foundation) and the Canadian Cancer Clinical Trials Network’s Canadian Remote Access Framework for Clinical Trials (CRAFT) initiative.

“This funding is an essential stepping stone to bringing more clinical trials to patients in northern B.C., in partnership with Northern Health,” said Dr. Olson.

The SABR-COMET-3 Phase III trial builds on the success of the previous Phase II trial which demonstrated that SABR can greatly increase survival rates in patients who had previously been treated for cancer only to have their cancer return in other parts of the body.

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