CANCERWISE- ICORG Summer 2002
The Membership of ICORG has grown steadily since October 1996 when 32 attended the inaugural meeting.
ICORG can currently count amongst its members all radiation, clinical, medical, haematological, and paediatric oncologists on the Island of Ireland, and also the great majority of surgeons who treat cancer.
As you can see from the two illustrative maps ICORG currently has 135 consultant members with 28 affiliated research staff. Those successful in 2001s National Cancer Institute/Health Research Board/Research & Development Office grant process are currently in the process of hiring staff and at least an extra 9 positions will be in place before the end of the summer. The research staff around the country have been the key to the many study successes. ICORG to date has in the first 5 years of its existence accrued more then 800 patients in all disease areas, with a current accrual rate across all studies of more then 20 patients per month.
Important Constitutional Changes within ICORG
The constitution of ICORG has very recently been changed by referendum so that future changes can be made on the basis of a majority vote.
A number of new amendments have been proposed and the executive are moving quickly to put these in place.
The most significant of these concern the make up of the membership and size of the executive committee.
– It is proposed that the membership be opened to include a broader range of those working in the area of cancer clinical research, it is envisaged that this will include bench scientists the focus of whose work is in the cancer clinical area and oncology research nurses and research co-ordinators/ managers.
– It is proposed that a separate haematology modality be initiated with the leader of this group sitting on the proposed expanded executive, similarly an elected leader of the clinical scientist/research professionals modality mentioned above would also sit on the executive.
This issue a focus on prostate cancer clinical research in Ireland
Prevalence of prostate cancer
Data released last week (6th June 2002) at a meeting in the European commission by Prof . Magnus Stenbeck, Centre for Epidemiology, National Board of Health and Welfare, Sweden indicted that the prevalence of prostate cancer is set to rise very significantly over the next 10-20 years.
The Swedes have a very impressive cancer registry that has been in existence since 1958. They also have computerised cause of death logs dating back to 1952. This has allowed this centre for epidemiology to look very accurately at trends in the various specific disease sub types.
The prevalence of prostate cancer is a combination of 4 elements:
* The incidence of the disease which is the number of new cases each year
* Changes in survival i.e life expectancy and or improvement in treatments
* Changes in population growth
* Changing age distribution within the population
For all four of these elements the effect in the prostate cancer population for Sweden is a significant increase over the next 15-20 years.
* The incidence effect will be a 6% increase in prevalence, adding survival improvements through better treatments brings this up to 37%, when you add the expected population growth and age distribution factors the net result is a 76% increase in the prevalence of prostate cancer by 2020.
Prof Stenbeck explained that these projections show that the current population of prostate cancer sufferers in Sweden 64, 538(1998) will grow to 85,000 in 2008 and will reach 113,200 in 2020.
As Ireland’s patient population characteristics would share many common aspects with Sweden it is probably a valid conclusion to assume that the prevalence of prostate cancer in Ireland will increase at a similar rate over the same time period. Hence the growing need for research in the area of prostate cancer.
ICORG Prostate studies:
Randomised trial of neoadjuvant hormones
Study supported by Ipsen
A randomised comparison of short and protracted neoadjuvant hormonal therapy prior to radiation therapy of high risk localised prostate cancer.
Between January 1997 and October 2001 a total number of 276 Irish men diagnosed with high risk or medium risk prostate cancer took part in an Irish designed research study aimed at improving the treatment of prostate cancer.
Although it has been established that hormonal therapy prior to radiation therapy for early, high risk prostate cancer is of some benefit, it is not known what is the best length of time to give this prior treatment.
This study was co-ordinated at St. Luke’s hospital, Dublin with the involvement of referring consultants from 19 other hospitals throughout the South and North of Ireland.
Ards Hospital Craigavon Hospital Sligo Regional Hospital Tralee General Hospital
Beaumont Hospital Limerick Regional Hospital St. Luke’s Hospital ,Dublin
Blackrock Clinic Mater Misericordiae
Hospital St. Luke’s Hospital, Kilkenny
Blanchardstown Hospital Mayo General Hospital St. Vincent’s University Hospital
Bon Secours Hospital, Cork Our Lady of Lourdes
Hospital St. Vincent’s Private
Cork University Hospital Portiuncula Hospital Tallaght Hospital
Points of note:
1. A record number of 276 Irish men were enrolled in this study. This represents the highest participation to date in Ireland for a single oncology study.
2. The study accrued ahead of target.
3. In its final year of accrual more then 80 patients were enrolled, this represented 28% of all possible eligible patients in the country. This accrual rate would compare very favourably with the top research institutions around the world and in fact is a great deal higher then most.
4. It is expected that the first results will be published in late 2003
Randomised trial of Taxotere in hormone refractory disease
Study sponsored by Aventis
A Multicenter Phase III Randomized Trial Comparing Docetaxel Administered Either Weekly or Every Three Weeks in Combination with Prednisone Versus Mitoxantrone in Combination with Prednisone for Metastatic Hormone Refractory Prostate Cancer.
This study is ongoing but has had a disappointing accrual rate.
The eight patients out of the target number of 30 have been accrued at these three centers:
The study has been extended by the sponsor following advice from the U.S. food and drug administration regulatory body and with a target number of more then 700 patients will now be the largest ever randomised phase III HRPC study. The current overall study accrual is very much on target with more then 600 patients enrolled. Ireland is behind the rest of Europe in this regard.
Randomised trial of Iressa in localised prostate cancer
Study sponsored by AstraZeneca
A Randomised Phase II Trial comparing combined Hormonal Therapy and Radiation Therapy with and without IRESSA for localised prostate cancer.
This study is very much on Target to open accrual in July 2002. It is an Irish designed Phase II protocol and has already passed many of the necessary start up steps.
ICORG will be holding a training week for oncology research staff* during the first week of July.
The aim of this week will be to provide intensive oncology specific training, workshops and specialist educational lectures for research staff working with ICORG members.
The cost is approximately 20% of that of a similar commercially run course. Most of the target audience have already been contacted but if you would like some more information please contact the ICORG office (01) 6621590
* please note that only oncology research staff associated with ICORG members may attend