Cancer therapy is defined as chemotherapy, radiotherapy, or other anti-cancer agent, which is given to either cure the disease or delay disease progression. Cancer therapy trials can either be small phase II trials to demonstrate the therapy is active in the affected patients, or large, randomised phase III trials which aim to provide firm evidence that a treatment is effective, compared to the current standard treatment. Therapies which are successful in phase II are evaluated further in phase III trials. A therapy which is successful in phase III can then be introduced into clinical practice, outside of a trial setting.
The first trial taken on by the unit was ZICE, a phase III non-inferiority trial of bisphosphonates in metastatic breast cancer to the bone. We then set-up two further large phase III trials, FRAGMATIC, a trial evaluating low molecular weight heparin in preventing large blood clots in the veins of patients with lung cancer, and SCOPE 1, a trial looking at the effect of adding Cetuximab to standard chemoradiotherapy in patients with oesophageal (gullet) cancer. These 3 trials are currently open to recruitment. We have recently set up a number of phase II trials, which will be taken forward to phase III trials if therapies are shown to be active. RT3VIN is assessing whether two topical treatment are active, safe and feasible treatments for in treating vulval intraepithelial neoplasia. SCALOP will evaluate whether chemoradiotherapy with either gemcitabine or capecitabine is active, safe and feasible in the management of patients with advanced pancreatic cancer. SUCCINCT and TOTEM are two trials that will assess whether new chemotherapy regimens with targeted therapies are active, safe and feasible for treatment of patients with advanced bladder cancer. The BOLERO trial will determine the feasibility of randomisation to open versus minimal access cystectomy in patients with muscle invasive bladder cancer.
The WCTU covers trials not only in cancer therapies, but also has trials in primary care (GP patients) and palliative care (management of patient symptoms when curative treatment is no longer suitable). Each of these areas has an associated working group, consisting of expert cancer clinicians and researchers based within Wales. The group is organised by Angela Casbard (Lead for Cancer Therapies) and chaired by Dr Richard Adams. It meets on a quarterly basis with the aim of developing trial ideas and providing support for up and coming Chief Investigators. Attendees are invited to present their trial ideas, which are then confidentially discussed. Ideas are either then developed by the researcher or reworked for the next meeting. Experts interested in joining the group should contact Angela Casbard or Richard Adams.
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