Early in his oncology career, a colleague shared a nugget of wisdom with Dr. Randeep Sangha, and it’s something that’s always stuck with him.
“I was told we may treat 5,000 patients throughout our career, but one positive clinical trial can help out hundreds of thousands of patients,” says Sangha, an oncologist and director of the Cross Cancer Institute’s (CCI) Clinical Trials Unit. “I think that’s one of the reasons why I like clinical trials — it offers that hope for a greater proportion of patients and advances the science of treating cancer”
This is particularly true for the CCI’s Clinical Trials Unit, which connects hundreds of cancer patients to cutting-edge therapies. The unit’s team includes over 60 investigators — researchers who are medical and radiation oncologists — who improve the prognosis and quality of life for patients diagnosed with all types of cancer by testing new treatments. Currently, the unit places more than 500 cancer patients on new drugs being trialled each year; this recruitment is the highest per capita in Canada. But the team has ambitious goals and hopes to increase that to 1,000 patients within the next five years.
The unit participates in international and national studies and offers a pathway for “made-in-Edmonton” trials.
“The CCI is able to get the trials we want because we’ve developed a good reputation among our partners,” says Sangha. The unit’s prestige enables it to participate in global research,
join medical conversations outside of Canada and bring in innovative therapies that CCI patients couldn’t otherwise access. Sangha says by participating in global trials, “you’re learning about new agents sooner rather than later.”
Sangha explains there are multiple ways the unit comes to participate in these international studies. Often, CCI researchers are directly approached to determine their interest in participating in industry-sponsored global trials. The CCI is known internationally for its data quality, accrual rates and researchers. Therefore, it is frequently determined to be one of the best Canadian trial sites for studies to be conducted. CCI researchers may also seek out innovative trials happening elsewhere in the world, which they might hear about through networking, and then ask to participate. The level of international collaboration depends on the trial; a phase 1 or 2 trial might involve weekly or monthly calls. A phase 3 trial will see the international researchers share their results at conferences or when working together to author a report.
As the Clinical Trials Unit director, Sangha oversees the launch and operation of all the unit’s trials, but he is also a researcher himself. For example, between 2015 and 2019, Sangha was the local lead for the ALEX trial, a global clinical trial with researchers from 35countries. It examined whether a state-of-the-art drug — alectinib — improved cancer outcomes for patients living with a rare mutation of an advanced lung cancer compared to the standard-of-care treatment. The results were overwhelmingly positive and Sangha says participating in the trial gave participants “earlier access to an agent that, ultimately, turned out to be better than standard-of-care.”
Simply, the CCI’s participation in global clinical trials can be an enormous benefit for patients.
“It’s a well-known fact that sites that participate in clinical trials [have better] clinical outcomes,” says Sangha. “Whenever anybody comes through our door on their cancer journey, there’s the possibility they’ll be able to enroll into a clinical trial.”
By The Numbers
The unit places more than 500 cancer patients on new treatments being trialled each year. This recruitment is the highest per capita in Canada.
At any one point, the unit is running 120 clinical trials from early phase 1 to phase 2, 3 or 4 studies.
Dr. Sangha estimates that between 60% and 70% of these are global trials.
14% of patients treated at CCI participate in a clinical trial. (The national average is about 8%.)