Role of Clinical Trials in Radiation Oncology: Lung Cancer Focus
Highlighting the crucial role of clinical trials in advancing radiation oncology treatments, with a specific focus on lung cancer. Dr. Wencesley A. Paez discusses the importance of sound scientific methods, building public trust, and improving patient outcomes through innovative cancer trials.
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Presentation Transcript
Radiation Oncology: The Role of Clinical Trials Focus on Lung Cancer Conference - October 28, 2022 Wencesley A. Paez, MD, MSHS Director of Clinical Research Department of Radiation Oncology Perelman Center for Advanced Medicine - University of Pennsylvania
No Financial Disclosures *Faculty Appointment George Washington University
Outline Background Why we do it? Basics of Clinical Trials Radiation Oncology Access to Clinical Trials (DIE initiatives) Future Considerations Summary
Clinical Trials Why do we do it? We need to build trust that the treatments we recommend are backed up by science The scientific methods need to be sound The intent of the researchers needs to be beyond suspicion Building the publictrust in medical research helps translate into the population
Translational Spectrum (T1 T4) From: Practice-Based Research Blue Highways on the NIH Roadmap JAMA. 2007;297(4):403-406. doi:10.1001/jama.297.4.403
Cancer Trials Improve upon Standard of Care Progression Free Survival (PFS) Overall Survival (OS) Local Tumor Control Screening Early Detection Quality of Life Patient Reported Outcomes (PROs) Questionnaires/Surveys
Radiation Oncology Technology Machines Imaging Delivery of Radiation Therapy Physics Dosing Types of Radiation Therapy Photon vs Proton Brachytherapy Combination Treatment Chemotherapy Different RT
Health inequalities and the social determinants of health are not a footnote to the determinants of health. They are the main issue. - Professor Sir Michael Marmot
Estimated that social, economic, and environmental drivers of health such as income, location of residence, and the quality of social-support networks can account for 80% of health outcomes - County Health Rankings & Roadmaps, National Academics of Sciences, Engineering, Medicine
Impacts prevalence of underlying cancer risk factors, including access to and uptake of preventive care early detection treatment survivorship care
Catchment Area (CA) 12-county area surrounding Philadelphia 81.4% of patients seen at ACC
Study Looking at Health Disparities - ACC ACC Cancer cases in ACC Catchment Area2 16.5% Adult treatment trials Adult non- therapeutic interventional trials 8.3% Adult non- interventional trials Catchment Area1 ACC patients 2014 19.0% 11.1% 12.2% 13.0% Gap between community and clinic Carmen E. Guerra et al. ASCO 2021
Study Looking at Health Disparities - ACC ACC Cancer cases in ACC Catchment Area2 16.5% 16.5% Adult treatment trials Adult non- therapeutic interventional trials 8.3% 33.1% Adult non- interventional trials Catchment Area1 ACC patients 2014 2018 19.0% 19.0% 11.1% 16.2% 12.2% 23.9% 13.0% 22.5% 1.9-fold increase 4.0-fold increase 1.7-fold increase Carmen E. Guerra et al. ASCO 2021
Community-based efforts to promote participation in cancer trials HALLMARKS OF STRATEGY: Build trust and establish bi-directional relationships Educational efforts about cancer clinical trials in Black communities in Philadelphia Programs to increase access to cancer screening Discussions with ACC Community Advisory Board Disease-specific community educational conferences New, culturally tailored ACC marketing strategies Strategies to mitigate transportation barriers for patients
18 Network Community Partners Addition of Two New Proton Centers Lancaster General Hospital (9/6) Virtua Health (Dec-Jan) Access to Care and Clinical Trials
Future Considerations FLASH Proton Therapy Virtual Reality (VR) Research Initiatives Collaborative Multidisciplinary Medical Oncology Other Oncologic Specialties
Summary Innovation must be Accessible to ALL Communities Penn Radiation Oncology strongly positioned to Leverage Access to Care and Clinical Trials Community Partnerships and Engagement is Essential for Building that TRUST
Acknowledgements Focus on Lung Cancer Conference Committee Abramson Cancer Center, Dr. Carmen Guerra Radiation Oncology Faculty Colleagues James Metz, MD Department Chair Costas Koumenis, PhD Vice Chair of Research John Plastaras, MD, PhD Vice Chair of Strategic Clinical Research Edgar Ben-Joseph, MD Vice Chair of Translational Research Patients
