2015-16 Cancer Network Annual Report

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Shannon Kriz, BSRS; Janete Mills, M.D., Radiation Oncology; Haley Wosk, RT, Sentara Albemarle Medical Center

Medical Oncology

Progressive Medicine and Clinical Trials

Within the Sentara Cancer Network, clinicians and academic researchers work together to elevate care for patients. This collaborative philosophy fosters innovation in the network and drives access to clinical trial options for our patients. Medical oncologists in our Sentara Cancer Network communities are especially instrumental in connecting patients with clinical trials — helping to achieve the Commission on Cancer’s principle to deliver quality care close to home.

There are promising clinical trials being conducted all over the country for patients with cancer, and many of these are accessible to patients in the Sentara Cancer Network. Patients report being motivated to help others in the future as well as having the opportunity to benefit from emerging cancer care practices. Opportunities to participate in clinical trials have opened up patient care options, including access to cutting-edge medicine. Our participation in clinical trials also contributes to cancer lab research via tissue donation, retrospective chart studies on control groups and participation.

Through collaboration with the NCI National Clinical Trials Network (NCTN), the Alliance for Clinical Trials in Oncology and NRG Oncology develop and conduct clinical trials with promising new cancer therapies. Through these collaborative efforts we utilize the best science to develop optimal treatment and prevention strategies for cancer, as well as research methods to alleviate side effects of cancer and cancer treatments.

Our longstanding partnership with the US Oncology Network, including Virginia Oncology Associates, provides access to the network’s more than 300 active clinical trials, contributing to research and approved cancer therapies.

Clinical Trials

Fluorescein Trial for Intracranial Lesions

Sentara Norfolk General Hospital
Neurosurgeon Dr. Wylie Zhu is the primary investigator, and the study looks at expanding the use of fluorescein angiography. While it has been in use since the 1960s, mainly for ophthalmology, the applications for the use of fluorescein angiography in patients with brain tumors is being assessed. Patients who are undergoing surgical intervention for the treatment of their brain aneurysm, tumor, arteriovenous malformation or fistula will have Yellow 560 Fluorescein Sodium injected to assess for conditions to be corrected. The advent of computer-assisted neuroimaging allows for more precise localization and more postoperative evaluations, and it’s possible that the use of fluorescein angiography may further improve surgeons’ ability to see and assess tumors.

Surgical Process for Endobronchial Navigation

Sentara Martha Jefferson Hospital
This quality study assessed use of a foot pedal controlled by the surgeon during an endobronchial navigation biopsy (ENB) to reduce the amount of patient exposure to fluoroscopy radiation. Prior to the study, patient exposure was approximately 10 minutes. During the case study reviews, the surgeon-controlled exposure time was 1½ to 1 ¾ minutes, reducing patient exposure by 83 to 85 percent. The conclusion of the study was that installing a foot pedal for surgeon use reduced patient exposure significantly.

Xoft Axxent eBX Clinical Trial

Sentara Northern Virginia Medical Center
The purpose of this trial is to assess the safety and efficacy of the Xoft Axxent eBx System when used for single-fraction IORT in early stage breast cancer. Sentara Northern Virginia Medical Center is one of 50 U.S. and international sites participating in the study.

Subjects in this study will be followed for 10 years comparing the Xoft Axxent System at the time of breast conserving surgery for early stage breast cancer compared to WBI. The objectives are to assess: the efficacy of single-fraction intra-operative radiation therapy; the rate of regional recurrence; the safety of single-fraction IORT; the rate of overall survival; cosmetic outcomes; and quality of life.

Clinical Trials Included:

  • Efficacy and Safety trials for investigational biologics
  • Combination trials for oncology drugs
  • Surgical and radiation therapy research trials
  • Adjuvant and maintenance drug trials
  • Postoperative oncology options
  • Retrospective chart review

Alliance for Clinical Trials in Oncology

Sentara is a member of the Alliance for Clinical Trials in Oncology. This cooperative group is part of the National Cancer Institute and is composed of a number of institutions working together.  The Alliance consists of nearly 10,000 cancer specialists at hospitals, medical and community clinics across the United States and Canada.  More recently, the network’s clinical trial participation was extended with membership in another cooperative group, NRG Oncology.