The UW Carbone Cancer Center conducts hundreds of clinical studies each year to safely develop better treatments for patients and to speed the process of discovery in cancer medicine. Often serving as the link between research in the lab and treatment in the clinic, these studies serve as the chief tool for doctors to safely examine potentially improved methods of care.
Carbone Cancer Center doctors and staff, like thousands across the nation, adhere to rigorous standards set forth by state and federal agencies to ensure safety in clinical studies, which are essential to furthering the mission of improving cancer care.
But Carbone Cancer Center clinicians don’t always do it alone. Often, they partner with other treatment facilities across the state as part of the Wisconsin Oncology Network serving patients in La Crosse, Oconomowoc, Wausau, Milwaukee and everywhere in between.
Anne Traynor, MD, who has led the Wisconsin Oncology Network (WON) since 2003, says the group’s mission consists of offering patients cutting-edge oncology care across Wisconsin and laying the groundwork for future care.
“It’s an opportunity for patients to receive the newest cancer medicines under development as close to home as possible with their own physician directing their care,” elaborates Traynor.
The number of Wisconsin Oncology Network sites has doubled since Traynor took the helm in 2003, meaning more patients across Wisconsin have the opportunity to receive treatments still in the process of federal approval. She says this speaks to the input of community partners participating in research.
“It moves the academic mission forward, while remaining focused on patients as individuals,” Traynor explains.
For many patients, taking part in a clinical study can be a way to aid in the greater mission of improving cancer care while receiving what could be a potentially life-prolonging treatment.
Patients participating in Wisconsin Oncology Network studies come from all corners of the state and beyond, so there is also a potential for greater diversity in a sample size. Greater diversity can in turn add validity to Wisconsin Oncology Network studies.
“The effort of all our research projects,” Traynor explains, “is to be able to generalize the findings from the sample population to the cancer population as a whole.”
For example, Wisconsin Oncology Network partners in Milwaukee might garner different findings than partners in Madison or Appleton based on population makeup.
Twice yearly, Wisconsin Oncology Network members from Wisconsin’s 18 partner institutions gather with other researchers, UW faculty, and pharmaceutical representatives to discuss the possibility of opening a clinical trial through the network. While the primary focus of the meetings is for attendees to discuss their research together, proposals for potential Wisconsin Oncology Network studies are often hashed out among the members – and opportunities for patient accrual are evaluated.
Ronald Go, MD, is a clinician at one of Wisconsin Oncology Network’s charter member sites, Gundersen Lutheran in La Crosse. Wisconsin Oncology Network trials are open to patients there as often as possible.
“We really feel a duty to the group and to public health in Wisconsin to support the trials,” says Go.
As a public health specialist, he also sees the value of offering the best and latest treatments to his patients.
“I feel an obligation to participate in research studies from Wisconsin Oncology Network because the only way we make progress is by working together,” he continues, “It’s a Wisconsin group, and as doctors we always feel more attached to something that’s close to our roots.”
It’s this sense of shared commitment that turns those who might be economic competitors into partners in care.
“With clinical studies, there are no guarantees,” says Go, “but if I don’t participate in a trial and it turns out to be a positive study, years could go by before the new treatment becomes commercially available.”
Go recently collaborated on a trial undertaken by Wisconsin Oncology Network affiliates testing the effectiveness of a drug combination to treat multiple myeloma. Jill Kolesar, PharmD, helped write the proposal for the trial in conjunction with Natalie Callander, MD.
“WON was used to increase accrual and to provide access to this clinical trial to people who might not be able to travel to Madison,” Kolesar explains.
Almost a quarter of the 39 patients accrued for the trial, known as “BEV/REV,” came from Wisconsin Oncology Network sites outside of Madison. The study combined three popular-but-expensive drugs used to treat multiple myeloma and was sponsored by the National Cancer Institute, winning out over dozens of other proposals. Wisconsin Oncology Network made it easier to find eligible patients for the BEV/REV study and made the new drug combination available to some who might not have otherwise received the medications.
As for the results: some patients in the trial who had a low level of a specific protein in their blood responded better to the treatment.
“Ten years ago, everyone with a disease got the same treatment,” explains Kolesar. “Today, using biomarkers like this, we can give patients more personalized care.”
“All of our patients are pre-screened for studies in which we participate,” says Go, “so everyone who qualifies has the opportunity to enroll in the trial.” Ultimately, Gundersen Lutheran accrued four patients for the BEV/REV trial, a number both Go and Traynor see as a success.
Traynor says accrual of patients from across Wisconsin adds robustness to the results.
“When we’re developing a novel treatment, we want to know how safe it is and how well it works,” she notes. “If we can administer a new drug combination in many different environments, then we can be more certain of its safety – and that really increases the strength of the whole study.”
“We want to continue to extend laboratory investigations to patients throughout the state,” Traynor says. “We’re all testing medicines. Most importantly we want to know how they will work and who will benefit.
“Given the Cancer Center’s support and the growth of the network, WON is primed to address translational needs throughout the state, applying basic laboratory findings to patient care as quickly and seamlessly as possible.”