Clinical trials blaze trails at Memorial

Medical technologist Paula Brunner performs a Complete Blood Count in a lab at Memorial Hospital. The hospital has increased clinical trials since affiliating with University of Colorado Health.

Medical technologist Paula Brunner performs a Complete Blood Count in a lab at Memorial Hospital. The hospital has increased clinical trials since affiliating with University of Colorado Health.

Irene Dollar was diagnosed with breast cancer in September 2013. The cancer soon spread to the Ordway resident’s lymph nodes in her left armpit. It was then that Dollar’s physician, Dr. Laura Pomerenke at Memorial Hospital, approached her with the possibility of participating in a clinical trial.

“They mentioned that they were going to try and remove only four lymph nodes instead of 20 from my armpit,” Dollar said. “It would be less invasive and quicken my healing time.”

Dollar said it would reduce her chance of developing lymphedema, a blockage in the lymphatic system, from 40 percent to 5 percent.

She said she is scheduled for radiation therapy this month, but as of her last mammogram, she is cancer-free. Regarding the clinical trial, however, doctors will measure swelling in Dollar’s left arm every six months for five years to determine whether she has symptoms of lymphedema or if the cancer may have returned.

“I did this because it’s non-invasive,” she said. “But I would have tried something else if I thought it would work.”

Strength in numbers

Memorial Hospital, as part of University of Colorado Health, is reaping the benefits of being part of a much larger network, especially when it comes to clinical trials, according to Renita Patrick, manager of research at the Cancer Center at Memorial Hospital.

Patrick said there has been “phenomenal growth” in the clinical trials program since Memorial became affiliated with UCHealth.

“A big benefit has been increased awareness and focus on research,” she said. “Not all growth is [due to the UCHealth affiliation], but we have grown exponentially here.”

UCHealth, which includes the University of Colorado Hospital in Denver, as well as Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland, brings a broad range of research resources to Colorado Springs, providing hope to local patients battling myriad serious ailments.

Patrick said being part of a larger network means help for patients could be just a phone call away.

“If we don’t have something to offer, we can call a colleague in Denver and tell them about a patient … and see if they have anything to offer, because we may be out of options here,” she said. “Affiliation provides us access to more innovative and early-phase research trials. That’s definitely a benefit of affiliating with an academic medical center.”

Patrick said patients are screened to be sure they fit the requirements of the trial and then they are presented with the option, generally through their physician. The patient is given the details of the trial and time to decide.

“It’s called an informed-consent decision,” Patrick said. “If they turn us down, fine. They’ll always get care here regardless of research. But if they participate, we become another partner on their care team.”

Patrick said, while not typical, some oncology trials follow patients for 20 years, and there are often misconceptions regarding research.

“With oncology, there are no placebos,” she said. “There aren’t any instances where the patient isn’t receiving treatment. There’s a perception by the public that you’re going to be a guinea pig or won’t get treatment at all. That’s unethical and won’t happen, especially in oncology.”

Patrick said some patients may receive “standard of care treatments,” which meets standard guidelines, while others may receive “novel treatments.”

Running LAPS

This spring, the Lead Academic Participating Site grant was awarded to the University of Colorado Anschutz Medical Campus from the National Cancer Institute. The NCI provides support for infrastructure and oversight of cancer clinical research trials at all UCHealth hospitals, and trial patients in Colorado Springs will benefit, according to Dr. Robert Hoyer, director of oncology at Memorial.

“With LAPS, we receive more funding for each patient,” he said. “And the LAPS grant allows system-wide oncology research. Trials open across the entire [UCHealth] system simultaneously and we can access that system from any point — Poudre Valley, Denver and Colorado Springs — and be part of the same clinical trial.” 

Patrick added that although Anschutz Medical Campus was the direct recipient of the grant, it never would have been awarded had the systems in northern and southern Colorado not existed.

“We would not be in the position we are currently in if we weren’t part of UCHealth and the University of Colorado Cancer Center,” Patrick said. “But without the network, the LAPS grant would not have been a possibility. Any facility alone would not have fit the requirements, but we do fit the requirement as a system. That means expanded trial offerings on a local level, including increased funding.”

Leading the way

While clinical trials exist for all sorts of ailments, Patrick said oncology research is “leading the way for system integration.”

“We look at how to ensure consistent practices across the system,” she said. Hoyer said that connection is what separates UCHealth trials from other systems.

“UCHealth is a unique collaboration between academic and community hospitals,” he said. “I believe, if implemented properly, we can leverage the strength of an academic enterprise and strengthen the community we serve.”

Hoyer added a single model for clinical trials would include a centralized structure and review board.

Patrick said Memorial Hospital has developed new mechanisms for screening and enrolling patients, and the program experienced a 40 percent increase in enrollment within the first year of implementation, which in turn encourages the hospital to invest and grow in research by “educating and promoting programs and continuing to look for additional opportunities to expand.”

“Nationwide, 1 percent of oncology patients are involved in trials,” Hoyer said. “Currently, at Memorial, we have just over 6 percent of our patients involved. That’s very exciting.”

Patrick said a driver in deciding to participate in clinical trials often has less to do with immediate payoff, but rather, the health of generations to follow.

 “What if this is my daughter in 20 years?” Patrick said. “What if this is my son? I have a chance to participate and change the face of cancer treatment. That’s empowering. Many cancer patients feel a loss of control throughout treatment and this gives them a chance to be in power.”

 “Trials are a great thing,” Dollar said. “It could help someone down the road. My doctor said five years from now, this will probably be an everyday surgery.” nCSBJ