Information Box Group
Ontario Clinical Oncology Group
Jim Wright
Director, OCOG
A cornerstone of ECRI, the Ontario Clinical Oncology Group (OCOG) is an academic-based clinical trials development and coordination organization. OCOG works with investigators to conceive, design, coordinate, conduct, analyze and publish clinical trials. Together with a network of local, provincial, national and international clinician investigators, OCOG, through clinical research, addresses clinically relevant questions, with the ultimate goal to impact and improve patient care. The OCOG Coordination & Method Centre (CMC) is located in the Juravinski Hospital and Cancer Centre.
ECRI members are principal investigators on a number of studies. OCOG is fortunate to have a team of faculty biostatisticians who are also methodologists and experts in clinical trials (Pond, Parpia and Julian (retired in 2020)). OCOG is conducting an exciting array of trials, including diagnostic imaging (e.g., FDG PET-CT), novel radiotherapy regimens, quality of care and immunotherapy.
Breast Cancer Radiotherapy Trials
Tim Whelan
Associate Chair, Research, Department of Oncology
Canada Research Chair in Breast Cancer Research
For many years, Dr. Whelan has led a research program evaluating novel radiation therapy regimens following lumpectomy or mastectomy. These trials have been multicentre often involving sites across Canada and even Australia. Often these trials have been landmark and practice changing. In an earlier trial called HYPO, a shorter regimen of sixteen fractions over three and half weeks was equivalent to the traditional twenty-five fraction five-week regimen thus shortening treatment by a week and a half. He then conducted trials which evaluated even shorter radiation courses. For example, in the RAPID trial, large doses of radiation per fraction given twice a day for five days to only part of the breast called accelerated partial breast irradiation (APBI) was compared with standard whole breast irradiation (WBI) for sixteen or twenty-five fractions with the goal of improving the convenience of treatment. Although, the risk of local recurrence was low in both groups, the APBI arm was associated with increased late radiation morbidity and adverse cosmetic outcome compared to the standard. This result discouraged the adoption of the APBI regimen. Dr. Whelan is still committed to making radiation regimens more convenient for patients (termed de-escalation). The LUMINA trial used biomarkers (ER, PR, Ki67) and traditional clinical pathologic factors (older age, grade and tumor size) to identify a group of patients who could be spared post lumpectomy radiotherapy. These results which were presented at the 2022 annual meeting of American Society of Clinical Oncology (ASCO) in Chicago will very likely be practice changing. Finally, a new trial called RAPID II funded by Canadian Institutes of Health Research (CIHR) compares five days of APBI (once a day) with fifteen days of WBI.
Palliative Care
Hsien Seow
Canada Research Chair in Palliative Care and Health System Innovation
Dr. Seow’s program of research focuses on interventions that increase access to palliative care, especially in the home and community, and improve patient and family experience. His research has been used to inform decision-makers to change policy, healthcare providers to change clinical practice, and patients and families to change their illness experience.
He has devoted much time and energy to CAPACITI (Community Access to PAlliative Care via Interprofessional Teams Intervention) which is an education program for primary care providers. Over three modules (twelve webinar sessions), it provides them with tools and practice supports to increase access to home-based palliative care for patients with advanced illness. CAPACITI is now being evaluated in a randomized trial funded by Canadian Institutes of Health Research (CIHR). The Government of Canada has provided funding to adapt the CAPACITI intervention to First Nations communities in Ontario.
