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Clinical Research in a Community Practice Bob Behrens, MD Iowa Oncology Research Association (IORA) What is IORA ? Local community physicians & staff Offer patients state-of-the-art research trials – – – – Prevention Diagnosis Treatment Symptom management Patients can get ‘cutting edge’ right at home What is IORA ? Established in 1978 by Dr. Fred Brunk Federally funded through NCI CCOP Main research base is Mayo system Capability of opening any nationwide trial 80 different research trial options open for patients in Des Moines in October 2008 How does a patient participate ? Match an open trial’s eligibility criteria Patient gives informed consent Guidelines specified for protocol treatment and follow-up Data shared with nationwide research base Audit (internal and external review) SELECT trial Selenium and vitamin E effect on prevention of prostate cancer 32,000 men nationwide (250 in Des Moines) Pills, bloodwork, exam for years ECOG 5202 Colon cancer molecular diagnostics trial ? Which stage 2 colon cancer patients need chemo ? Specific chromosomal changes are assessed to determine high vs. low recurrence risk If low, observe – no chemo If high, 2 chemo options E5103 High risk adjuvant breast cancer treatment Women after all known cancer surgically removed Standard chemotherapy with or without bevacizumab N05C3 Trial to assess if vitamin E can prevent neuropathy side effects of chemo ½ of patients get vitamin E, ½ get placebo Patients receive standard chemo for their cancer Neuropathy incidence and severity recorded by patient and by doctor Barriers to Research Participation Patients or doctors informed on all options Time commitment Demographics Insurance Comorbidities ‘Guinea pig’ perception IORA Questions ?