Dr Jha on Community Accrual to the ECLIPSE Trial in Prostate Cancer

Gautam Jha, MD, medical director, M Health Fairview Masonic Cancer Clinic and the Advanced Treatment Center at the M Health Fairview Clinics and Surgery Center—Minneapolis, chair, cancer committee, M Health Fairview Ridges Hospital, discusses the advantages of collaboration between community and academic oncologists to enroll patients to clinical trials, noting the efforts by the University of Minnesota and surrounding community cancer centers to accrue patients to the phase 3 ECLIPSE trial (NCT05204927).

This clinical trial evaluated the radioligand 177Lu-PSMA-I&T vs standard-of-care hormone therapy with abiraterone acetate (Zytiga) or enzalutamide (Xtandi) in patients with metastatic castration-resistant prostate cancer (mCRPC) who experienced progressive disease and received prior treatment with an androgen receptor–directed therapy.

The utilization of novel treatment modalities, specifically radioligands targeting prostate–specific membrane antigen (PSMA), represents another potential treatment path for patients with mCRPC, Jha begins. Notably, the targeted nature of this therapy limits toxicity, thereby enhancing patient acceptance and enthusiasm. Importantly, this treatment strategy delays the initiation of chemotherapy, offering patients a preferable alternative to conventional therapies, he adds.

The collaborative partnership between the University of Minnesota and community oncologists facilitated successful trial accrual, according to Jha. This collaboration addressed common patient needs across both settings, aligning with the shared goal of accessing cutting-edge research and minimizing logistical burdens for patients and their families, he explains.

Furthermore, community oncologists are often entrenched in conventional practices and overwhelmed with patient care responsibilities, presenting a challenge to clinical trial enrollment, Jha says. However, proactive engagement and outreach efforts by academic institutions to leverage existing professional networks can mitigate these barriers. Jha notes that his experience in leveraging local connections and relationships with neighboring oncologists illustrates the effectiveness of such collaborative approaches in enhancing trial accrual rates.

Bridging the gap between academic and community oncologists not only benefits patient access to innovative therapies but also fosters professional satisfaction among referring physicians, Jha continues. By offering cutting-edge treatments within their local communities, referring physicians retain patient continuity and contribute to advancing medical knowledge and therapeutic options, he concludes.

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Gautam Jha, MD, discusses collaborative efforts between community and academic oncologists to accrue patients to the ECLIPSE trial.



Drs Antonarakis and Jha on Extending Clinical Trials to the Community Setting

Emmanuel Antonarakis, MD, associate director, Translational Research, Masonic Cancer Center, University of Minnesota, Clark Endowed Professor of Medicine, University of Minnesota Medical School; and Gautam Jha, MD, medical director, M Health Fairview Masonic Cancer Clinic and the Advanced Treatment Center at the M Health Fairview Clinics and Surgery Center—Minneapolis, chair, cancer committee, M Health Fairview Ridges Hospital, highlight the significance of collaboration to extend the reach of clinical trials beyond the confines of university hospitals, thus enhancing patient accessibility and engagement within the community setting.

In particular, Antonarakis and Jha discussed the collaborative effort used by the University of Minnesota and surrounding community cancer centers to drive enrollment to the phase 3 ECLIPSE trial (NCT05204927), which evaluated 177Lu-PSMA-I&T vs standard-of-care hormone therapy with abiraterone acetate (Zytiga) or enzalutamide (Xtandi) in patients with metastatic castration-resistant prostate cancer (mCRPC) who experienced progressive disease and received prior treatment with an androgen receptor–directed therapy.

By partnering with community oncologists affiliated with the University of Minnesota, the goal was to broaden the trial’s patient pool. Although 177Lu-PSMA-I&T, which is a radiopharmaceutical, required administration at the University of Minnesota due to safety protocols, patient identification and recruitment efforts were decentralized to community settings, Antonarakis says.

Jha underscores the practical benefits of this collaborative approach, particularly in alleviating the burden of travel for patients—a factor often impeding trial participation for those being treated in the community. Leveraging existing networks within the community, Jha explains that he and his team effectively engaged local oncologists to identify potential candidates for the trial.

Jha's commitment to supporting his colleagues in identifying eligible patients underscores the collaborative ethos driving this endeavor. This collaborative model demonstrates a pragmatic approach to trial recruitment, capitalizing on the strengths of both academic and community oncology settings.

By decentralizing patient identification and engagement efforts, the trial effectively satisfied its reach and potential impact on advancing prostate cancer research and treatment options for patients near and around the University of Minnesota, they conclude.

Emmanuel Antonarakis, MD, and Gautam Jha, MD, on collaboration efforts extending the reach of clinical trials beyond university hospitals.

Drs Jha and Antonarakis on Collaboration Between Community and Academic Oncologists

Gautam Jha, MD, medical director, M Health Fairview Masonic Cancer Clinic and the Advanced Treatment Center at the M Health Fairview Clinics and Surgery Center—Minneapolis, chair, cancer committee, M Health Fairview Ridges Hospital; and Emmanuel Antonarakis, MD, associate director, Translational Research, Masonic Cancer Center, University of Minnesota, Clark Endowed Professor of Medicine, University of Minnesota Medical School, discuss the practicality and advantages of collaborative efforts between community and academic oncologists.

By addressing logistical challenges and dispelling historical misconceptions, both physicians hope that the broader oncology community can work toward a more inclusive and collaborative approach to cancer research and patient care. The physicians outline several hurdles faced by community practitioners, noting potential limitations in awareness of all currently available clinical trials, as well as the broad spectrum of patients with cancer they treat in practice. Unlike university oncologists who specialize in specific cancer types, community oncologists must stay abreast of developments across various spaces, posing a significant challenge in remaining fully informed on clinical trial options and recommendations across all disease states.

Highlighting historical misconceptions surrounding the relationship between academic and community oncologists, Antonarakis emphasizes the evolving dynamic characterized by mutual respect and collaboration rather than rivalry. He also explains that community oncologists should perceive academic colleagues as valuable resources for discussing complex cases, rather than only referring patients to academic centers for clinical trials. He stresses the ethical imperative of returning patients to their community physicians if they do not meet trial eligibility criteria, emphasizing the need to avoid any perception of patient poaching.

Both physicians mention the imperative nature of maintaining patient-centered care and fostering collaboration to enhance clinical trial enrollment. Jha highlights the logistical challenges faced by community oncologists, underscoring the need for increased support and resources to facilitate trial participation. He notes the importance of addressing time constraints and adds that adequate training and support is required to enable community oncologists to effectively overcome these barriers.

Antonarakis discusses the importance of dispelling misconceptions and fostering a collaborative spirit between academic and community oncologists. He says clinicians have an ethical obligation to prioritize patient care and maintain strong relationships with referring physicians. By ensuring open communication and mutual respect, Antonarakis suggests that the oncology community could work toward overcoming existing barriers to trial enrollment and fostering a more inclusive and collaborative approach to cancer research and care.

Gautam Jha, MD, and Emmanuel Antonarakis, MD, on the advantages of collaborative efforts between community and academic oncologists.

Gautam Jha, MD

Articles

Dr Jha on Community Accrual to the ECLIPSE Trial in Prostate Cancer

Drs Antonarakis and Jha on Extending Clinical Trials to the Community Setting

Drs Jha and Antonarakis on Collaboration Between Community and Academic Oncologists