Friday, July 25, 2003

By Anita Srikameswaran, Post-Gazette Staff Writer
 

Only a small percentage of people eligible for cancer treatment trials actually join the studies, so local scientists will try to boost participation by making more studies available in community settings rather than only in research hospitals.

The University of Pittsburgh Cancer Institute is one of six centers in the nation that will be sharing a two-year, $5.6 million grant to develop models of systems that make it easier for people to join clinical trials. The award was created through a unique partnership of the National Cancer Institute and the Foundation for the National Institutes of Health and several drug companies, including Aventis, Bristol-Meyers Squibb, Eli Lilly and Co., GlaxoSmithKline and Novartis.

"Each model from the six [cancer] centers is somewhat different," said lead researcher Dr. Samuel Jacobs, associate director of clinical investigations at the UPMC cancer centers. "Some will target minorities, the disadvantaged, [or] rural communities."

All focus on people who don't typically volunteer for clinical trials or have access to them, he added.

The UPCI model has the Hillman Cancer Center in Shadyside at its hub and its centers in Greensburg, Wexford and Clairton as satellites. The satellite centers, in turn, will act as a resource for oncology practices in their regions.

"We're going to try to take some of the investigative trials that are done at the Hillman and try to be able to do them in these centers," Jacobs explained. "The vast majority of cancer patients are actually treated in their communities. This is an effort to bring the best we have, the newest and most pioneering treatments, out into the community sites."

To do that, resources will be needed to support physician and nurse efforts, mechanisms must be created to transport biological samples into the main center for analysis, and patients must be made aware of opportunities to participate in research.

Jacobs said that increasing recruitment in early phase trials is particularly important. Advances in molecular biology have led to an explosion of new cancer drugs.

"There are so many more agents available that need to be tested to determine if they're going to have an impact," he said. "While they may look promising in the test tube, the only way to know is when they're used in clinical trials."

At academic centers like the Hillman, about 15 percent of adult cancer patients join research studies. But in community settings, where most patients are treated, participation drops to about 3 percent, Jacobs said.

That might happen because community physicians and nurses don't want to dedicate some of their time to conducting research, or patients are reluctant to try experimental treatments or can't get to a center where trials are being done.

Part of the project is "to look at what some of those barriers are and how we can overcome them," Jacobs said.

About 850 people joined UPCI studies last year, Jacobs said. The goal is to increase that number to 1,500 through several initiatives, including the new project.

For more information about the UPMC cancer centers, go to www.upmccancercenters.com or call the cancer referral service at 1-800-237-4724.

(Anita Srikameswaran can be reached at anitas@post-gazette.com or 412-263-3858.)