The Division of Medical Oncology and Hematology at Princess Margaret is an international leader in advancing the frontiers of cancer treatment and management through our commitment to clinical and translational research and the development of new cancer therapies.
Offering Phase I and Phase II evaluation of new agents, through to Phase III trials that establish new treatment standards, our team members lead both large and multi-centre trials. Trials are carried out within the context of our Robert and Maggie Bras and Family New Drug Development Program, the Philip S. Orsino Cell Therapy Program and the Division of Medical Oncology Research Program and Clinical Trial Support Unit (a component of the Cancer Clinical Research Unit).
Positively affecting patient outcomes and care is the purpose behind all our research and clinical trials.
As part of the largest medical oncology and hematology program in Canada, our researchers work with a large base of people with common, rare and complex forms of cancer. Our experts have access to the most cutting-edge diagnostic and research imaging technology.
Our scientists and physician investigators are principal investigators, co-investigators or collaborators on a large range of research initiatives and have received funding through peer-reviewed and sponsorship grants.
Phase I Clinical Trials Program
Our solid tumour Phase I program is the largest early phase cancer clinical trial program in Canada and is one of the top-rated programs of its kind worldwide. The program conducts investigator-initiated early-phase clinical trials and correlative studies with novel anti-cancer agents or combinations, including novel immuno-oncology drugs. Since its creation, the Phase I program has steadily enrolled about 250-270 solid tumour patients a year, offering many Canadian patients the opportunity to enrol on new anticancer drug studies without having to travel abroad.
The Phase I team includes 5 staff medical oncologists (Dr. Lillian Siu, Dr. Philippe Bedard, Dr. Albiruni Razak, Dr. Aaron Hansen, and Dr. Anna Spreafico), 4-6 clinical research fellows, 6 dedicated research nurses, 2 pharmacokinetic nurses, 1 investigational drug pharmacist, 1 program manager, 2 assistant program managers, 1 clinical trial specialist, 1 tissue coordinator for trial screening, 12 clinical study coordinators, 2 regulatory coordinators, 1 financial analyst and 1 grants and contracts specialist. In addition, the Phase I Program is operationally supported by the Correlative Science Program which handles, processes and ships biological samples collected in clinical trials. The Phase I Unit at the Princess Margaret Cancer Centre includes six inpatients beds for monitoring, seven outpatient assessment beds, and a designated room equipped for pharmacokinetic sample processing and storage.
Since 2008, the Phase I program continues to be supported by an award from the United States National Cancer Institute and is one of thirteen Consortia members of the Experimental Therapeutics Clinical Trials Network (ETCTN). Based on the high calibre of research the group is conducting, major pharmaceutical companies such as Novartis, BMS, Merck, GSK, Pfizer and Genentech/Roche have selected the program as a preferred partner. The Phase I program is known for its efficiency in activating new clinical trials. In 2017, it took an average of 66 days for the Phase I program to activate 18 new clinical trials and to enrol its first patients into these new trials after submission to the Institutional Review Board for regulatory approval.
The Phase I program is known for its expertise in conducting first-in-human clinical trials. In 2018, the types of novel anticancer agents evaluated by the Phase I program includes:
- Immune checkpoint inhibitors beyond anti-CTLA-4 and anti-PD1/L1 antibodies
- Co-stimulatory molecules
- Functional modification of immuno-suppressive enzymes
- Myeloid cell modulation
- Personalized cancer vaccines
- T cell bispecific antibodies
- Adoptive cell therapy
- Oncolytic viruses
- Intratumoural immunotherapy
- Novel molecularly targeted therapy
- Chemotherapy, radiotherapy or targeted therapy in combination with immunotherapy
Drug Development Fellowship Program
A very unique aspect of the Phase I program at the Princess Margaret Cancer Centre is that it is aligned with the Drug Development Program Fellowship training program. The goal of the Drug Development Program Fellowship Program is to train early career investigators in experimental therapeutics and translational research. The Drug Development Program Fellowship Program is directed by Dr. Philippe Bedard and includes 4-6 clinical research fellows annually.
The Drug Development Program Fellowship Program is a world class training program in experimental therapeutics and have consistently attracted trainees worldwide, including Europe, South America, Australia and Asia. Fellows accepted to the Program are expected to complete at least two years of additional training in early Drug Development following their board certification in Medical Oncology in Canada or another jurisdiction. There is a structured curriculum that includes active participation in the planning, coordination and implementation of selected clinical trial protocols mounted by the Drug Development Program. Many graduates of the Drug Development Program Fellowship have become world class leaders in experimental therapeutics upon return home with the knowledge base and skill set acquired. This unique program has trained over 40 young oncologists over the past two decades.
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Phase II Clinical Trial Consortium
Led by Amit Oza, the Princess Margaret Phase II Trial Consortium is one of seven sites—and the only non-US site—funded by the National Cancer Institute. Since 2001, the consortium has made novel single cancer agents or combination agent treatments available through clinical trials.
Trials investigate National Cancer Institute Cancer Therapy Evaluation Program (NCI CTEP) sponsored agents with translational emphasis on evaluating the biologic effects of agents on molecular targets, disease biomarker discovery and validation, and the widespread implementation of standardized operating procedures.
Ensuring quality and process improvement is inherent in all studies. With access to state-of-the-art clinical research facilities, the contract allows the consortium to conduct innovative clinical trials with promising combination therapies that are pivotal for drug development. Princess Margaret consortium–led studies evaluating the prognostic or predictive value of biomarkers are done in collaboration with NCI/CTEP/Cancer Human Biobank initiatives.
Drawing on expertise from across the organization, the consortium has particular strength in gynecologic malignancies, gastrointestinal cancer, head and neck cancer, prostate/genitourinary malignancies, breast cancer, leukemia and Phase I clinical trials. In partnership with the Department of Medical Imaging, the Princess Margaret consortium has access to a strong group of imaging experts and advanced diagnostic and research imaging technology that contributes an added level of complexity to future trials with detailed functional imaging.
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