Windsor enrolment program for cancer clinical trials to expand into Thunder Bay and Winnipeg

A Windsor, Ont. program that helps connect cancer patients to clinical trials is now planning to expand after receiving its first national grant. 

The Clinical Trials Navigator program, founded by Caroline Hamm, helps people with cancer find alternative and experimental treatments by connecting them to clinical trials they are eligible for.

The program was also developed alongside former Windsor Regional Hospital board chair and cancer patient Ron Truant.

"What we do is we navigate a system that is really difficult for everybody to navigate," says Hamm, who is a medical oncologist at Windsor Regional Hospital's cancer program. 

"If someone is on a cancer journey and they get to a point where the standard treatments are just not going to give them a long time to live, they do start looking for options and the best options are through a clinical trial."  

This month, Hamm and her team received a $198,000 Canadian Institutes of Health Research (CIHR) grant. The funding will allow them to expand the program by hiring team members who will work in Winnipeg and Thunder Bay. 

She said the program started about a decade ago, and, over that time it has worked with 302 patients. Of those, 24 per cent were referred to a clinical trial and eight per cent were actually enrolled in one. 

Dr. Philip J. Devereaux, principal investigator of the Accelerating Clinical Trials (ACT) consortium in Canada, has been working to make clinical trials more accessible. He said Hamm's program is an especially important one. 

"Advances in health care have been enormous in the last several decades and that's on the back of research and when it comes to therapies you need randomized controlled trials, that is the gold standard for determining whether therapies work," he said. 

"Many patients have had their lives saved through clinical trials ... [and] that's how we figure out what works." 

In smaller centres, like Windsor, or rural parts of the country, patients often don't have easy access to clinical trials. 

On average, Hamm said Windsor has about 10 to 15 trials running. So, if you're a cancer patient in the border city, it's unlikely one of those will match your specific type of cancer. 

"Even if we find trials for people, often they'll decide not to go, but they're happy to know that they have that option," she said.

"It gives them back that control." 

Program looking to reduce barriers

When it comes to joining a clinical trial, Hamm said Canadian patients don't pay for the trial itself, but they do have to pay for their transportation or accommodations if they need to travel. 

In the United States, Canadian patients would have to pay to join the trial, but Hamm said her team tries to work out deals with the researchers. 

She said they are also trying to find resources that could help support patients. 

As Hamm and her team work to expand to Winnipeg and Thunder Bay, she said they are being mindful of Indigenous patients by creating a training program for navigators to work with the community and also speak with their Indigenous partners. 

Efficiencies need to be created, says expert

On top of it being essential for Canadians to more easily access clinical trials, Devereaux said Canada needs to improve at attracting this type of research. 

He said bureaucracy has "limited" some trials coming to Canada. 

"We are a large country land-wise, but we're a small country in terms of population, so for novel therapies and companies to say, 'hey we're going to test our new drug or intervention, let's go to Canada,' we have to be really efficient in order to make it worth their while to come here," said Devereaux.

For example, he said trials happening at multiple centres across the country currently require many approvals from the Research Ethics Board, but in other countries only one is needed.  

When it comes to Hamm's program, Devereaux said he'd like to see non-cancer patients also have access to support when looking for clinical trials. 

And he said the process of joining a clinical trial in general should become more automated, so that all Canadians can access them.