May 6, 2021
Canadian Remote Access Framework for Clinical Trials brings new opportunities for cancer patients residing in rural and remote communities
The Canadian Cancer Clinical Trials Network (3CTN), has launched the proof-of-concept phase of the Canadian Remote Access Framework for Clinical Trials (CRAFT), which aims to broaden trial options for eligible cancer patients, regardless of where they live in Canada. Clinical trials are an important part of the cancer care system, particularly for those who have exhausted standard treatment options. Those who are far from a regional cancer centre where a trial may be available often face immense hurdles to participating, such as travel cost and time. CRAFT employs a hub and spoke, ‘trial cluster’ model, wherein the trial centre provides oversight for a patient’s community health centre to serve as a satellite site.
With funding support received from the Canadian Partnership Against Cancer, CRAFT was created by a collaborative group of patient partners, clinical researchers, trial sponsors, healthcare institutions, research ethicists and representatives from Health Canada who were united in a common vision to promote equity in the cancer system through improved opportunities for clinical trial participation for all eligible Canadian patients. When fully implemented, CRAFT aims to address many of the regulatory, ethical, legal and practical barriers that can impede the conduct of clinical trials in rural and remote communities.
Through CRAFT, centres interested in collaborating on a given trial can draw from resources created to support setup and oversight that assures patients receive the same level of quality and safety regardless of where they are seen. Funding provided by 3CTN will support proof-of-concept of CRAFT at three locations across Canada over the coming year:
Primary centre: Health Sciences Centre, Eastern Health: St. John’s, Newfoundland and Labrador
EXCITE Corporation/Central Newfoundland Regional Health Centre (Grand Falls – Windsor)
Western Memorial Regional Hospital (Corner Brook)
Leader: Dr. John Thoms
Primary centre: Health Sciences North: Sudbury, Ontario
Sault Area Hospital
Timmins District Hospital
Leader: Dr. Lacey Pitre
Primary centre: BC Cancer: Prince George, British Columbia
Mills Memorial Hospital (Terrace)
Kootenay Boundary Regional Hospital (Trail)
Leader: Dr. Robert Olson
“I am thrilled that through the CRAFT initiative we can start eliminating the barriers that exist for cancer patients in rural and remote communities in Canada,” says Dr. Janet Dancey, Scientific Director of 3CTN. “Thank you to all of our partners who came together to create a truly innovative solution that will move us closer to achieving equity in access to cancer clinical trials. We are confident that this proof-of-concept project will show that CRAFT is an effective approach and provide a springboard to expand the initiative.”
“As Newfoundlanders and Labradorians, we have all experienced challenges with regards to access to healthcare. Our beautiful province can act as a major barrier when considering accessibility to clinical trials for cancer patients living outside of the metro region. Everyone deserves access to the best possible level of care, despite geographic location,” says Stephanie Mayne of Newfoundland and Labrador, a patient partner and CRAFT working group contributor. “CRAFT provides us the opportunity to overcome these barriers and improve access to clinical trials. I am extremely proud to say that patients played a key role in shaping the framework and look forward to seeing its success.”
“We are excited to partner with local health authorities in B.C., including Northern Health and Interior Health, to facilitate clinical trial follow-up in patients’ home communities,” says Dr. Robert Olson, of BC Cancer in Prince George, B.C. “General practitioners in partner communities will undergo clinical trial training and help with patient follow-up, physical exams, and adverse event reporting, enabling patients from more remote communities, including First Nations, to commit to the multi-year follow-up programs needed for clinical trials.”
“Conducting clinical trials is a complex undertaking as there are many factors that must be considered such as regulations, trial requirements and the patient’s needs. CRAFT provides us with a comprehensive approach to conducting clinical trials in community hospitals by giving us the tools and resources we need to reach patients in remote communities,” says Christopher Lavoie, Clinical Research Supervisor at Health Sciences North in Sudbury, Ontario. “Our team is excited to be one of the first to implement CRAFT and we can’t wait to see the positive impact it has on patients in our communities and beyond.”
About the Canadian Cancer Clinical Trials Network
Established at the Ontario Institute for Cancer Research (OICR) in 2014, the Canadian Cancer Clinical Trials Network (3CTN) is a not-for-profit, pan-Canadian initiative aimed at supporting and improving the efficient delivery of academic cancer clinical trials through funding, resources and advocacy to improve the clinical trial environment and increase patient access to cancer clinical trials. Clinical trials are a vital component of Canada’s cancer care system and are essential to advancing cancer research to bring new solutions to patients. Funding for 3CTN operations is provided by OICR and the Canadian Partnership Against Cancer. Core funding for 3CTN member cancer centres is provided by provincial cancer agencies.
October 23, 2020
This year, more than 5,700 people with cancer received innovative treatments or interventions through participating in clinical trials supported by the Canadian Cancer Clinical Trials Network (3CTN). Today, 3CTN has published their 2019-2020 Annual Report, highlighting their progress made towards enhancing the impact of academic cancer clinical trials across Canada. The report marks the midpoint of their strategic plan for 2018-2022.
Highlights of the report include feature articles on:
- How 3CTN has boosted recruitment for their supported trials by nearly 130 per cent, surpassing all expectations and targets;
- New Network initiatives such as improving trial options for children and people outside of urban areas;
- The tools and technologies that are streamlining and standardizing clinical trial management;
- The patient representatives who play a key role in the success of the Network.
August 13, 2019
The Canadian Cancer Clinical Trials Network launches new pilot project at Windsor Regional Hospital to help patients understand their treatment options and access current clinical studies
In early 2012, Ron Truant, the former Board Chair of Windsor Regional Hospital (WRH), became a patient when he was diagnosed with pancreatic cancer.
Facing a disease with a dismal prognosis, Ron and his wife, Noella Truant, made an appointment for a second opinion at a hospital outside of Windsor. It was there that the Truants learned about an open clinical trial and secured the study’s last available spot.
Noella says not everyone is as fortunate as they were.
“We were lucky to gain access to an immunotherapy trial, which – in combination with a new chemotherapy treatment – gave us another four years together,” says Noella. “Throughout his own treatment, Ron was always thinking about others and realized there were many others who weren’t as fortunate as we were to find a trial. He knew that trials are complex and not everyone can navigate them, so he saw an opportunity to help.”
Last year, only eight per cent of cancer patients in Ontario were recruited to clinical trials and in community hospitals, like WRH, that number drops to fewer than two per cent. These statistics, Noella says, indicate that patients are missing opportunities to gain access to new treatment options and contribute to clinical research.
Currently, each cancer centre in Ontario has a clinical research team that recruits patients for available trials at their respective sites but patients, like Ron, often want to explore all treatment options, including those at other nearby hospitals. These patients and their care givers are frequently left to research trials on their own through websites that may not contain current information or online trial databases that may be difficult to navigate. Even if a patient finds an available trial, understanding eligibility criteria requires specialized knowledge and advanced medical literacy.
Ron, a long-standing advocate for the quality of patient care, teamed up with Dr. Caroline Hamm, an oncologist at the WRH, to develop a better way for patients to navigate clinical trials.
“We want to make sure patients are offered the best treatments available for their individual needs, and that requires more than a database of trials,” says Hamm, who is also the Director of the Windsor Cancer Research Group. “There are many considerations that a patient weighs when deciding to participate in a trial and we need a more considerate approach to help patients with these decisions.”
With support from the Canadian Cancer Clinical Trials Network (3CTN), Hamm and the Truants designed a program where a designated clinical trials specialist – a Clinical Trials Navigator – would help patients find and understand the trials available. A patient could refer themselves to the navigator or they could be referred to the navigator by their oncologist. After reviewing the patient’s case and considering their preferences, the navigator could then identify available trials for which the patient is likely eligible, and help facilitate the connection between a patient and the study team.
Hamm, in Ron Truant’s legacy, launched the Clinical Trials Navigator pilot project at WRH in January and so far the project has since helped more than 40 patients explore trial options.
Youshaa El-Abed, the project’s navigator, sees the impact of this initiative on patients and their care givers first-hand.
“When a patient comes to us, they’re looking for a trial,” says El-Abed. “But even if there are no trials available for them, the patient – and their loved ones – gain reassurance that they have explored their options.”
Due to growing demand for clinical trial navigation services at other hospitals, the project is now open to receive patient referrals from across Ontario.
Hamm, who has been recognized for her patient advocacy in Windsor, hopes to expand this initiative to new sites as she has in the past for a cancer drug access coordinator program. In addition to helping current patients with cancer, Hamm sees the Clinical Trials Navigator project as a way to accelerate clinical research so patients can benefit from research sooner.
“If we can help patients access trials, we can help trials reach their accrual targets sooner – a win-win for patients and for local clinical research,” says Hamm. “A health system with accelerated clinical research allows us to attract more study sponsors, bringing leading edge treatment options to our hospitals. Ron envisioned this solution and we’re proud it’s in action today.”