Prince George

Researchers are evaluating a phase III randomized trial comparing standard care treatment alone to standard care plus Stereotactic Ablative Radiotherapy SABR for patients with up to 10 oligometastases and a synchronous primary tumor. Patients are assigned in a 12 ratio to either receive palliative radiotherapy or a combination of standard care and SABR. Participants are stratified based on cancer histology and number of metastases to better understand treatment outcomes. The trial includes two groups the standard arm receiving palliative radiotherapy aimed at symptom relief or preventing complications, and the experimental arm receiving treatment to both the primary tumor and metastases, with SABR preferred but other options like surgery, radiofrequency ablation, or fractionated radiation allowed if deemed better by oncologists. SABR doses typically range from 20 Gy in 1 fraction to 35 Gy in 5 fractions. Chemotherapy, hormone therapy, immunotherapy, targeted systemic therapy, or observation follow standard care approaches. Participants will undergo restaging imaging, performance status assessments, and monitoring for adverse effects over approximately six years. Researchers will measure overall survival as the primary outcome, with secondary outcomes including quality of life evaluations using FACT-G and EQ-5D-5L questionnaires, toxicity assessments by CTCAE, time to next systemic therapy, and receipt of additional radiation. Safety follow-up and detailed quality of life data collection take place mainly during the first two years of the study.

Researchers are evaluating the effectiveness of Pumitamig compared to Pembrolizumab in adults with previously untreated advanced Non-Small Cell Lung Cancer NSCLC who have a PD-L1 expression level of 50% or higher. This Phase 3 randomized, double-blind study focuses on patients with locally advanced or metastatic NSCLC to better understand first-line treatment options. Participants receive either Pumitamig or Pembrolizumab as the study drug, given at specified doses on certain days. The study uses a parallel design with two treatment groups to compare these therapies as first-line options. The study is planned to continue until October 2031, with treatment and follow-up periods extending up to approximately 5 years for overall survival assessments. During the study, participants will have regular assessments to monitor disease progression and response to treatment using criteria like RECIST v1.1. Researchers will evaluate progression-free survival, overall survival, objective response rates, duration of response, disease control rate, and symptom changes related to lung cancer over time. Safety and treatment effects will be closely monitored throughout the study duration.

Researchers are evaluating a new approach to adjuvant treatment for patients with early-stage endometrial cancer characterized by POLE mutations or p53 wildtypeno specific molecular profile. This Phase II study compares this tailored treatment approach to the usual care, which typically involves surgery followed by additional therapy decisions based on pathology results. The study includes two sub-studies focusing on these molecular types of endometrial cancer. Participants may receive one of several interventions including observation alone, observation combined with adjuvant radiotherapy, or observation combined with vaginal brachytherapy. Radiotherapy uses specific photon energies and imaging for treatment planning, while vaginal brachytherapy is delivered with a vaginal cylinder or ovoids. Treatment starts within 10 weeks after surgery, and patients are assigned to groups based on their tumor molecular status. During the study, participants are monitored for recurrence rates in the pelvis, vagina, para-aortic area, and distant sites over 3 years, as well as recurrence-free survival, cancer-specific survival, and overall survival over 9 years. Patient-reported outcomes on fear of recurrence are also collected. Careful follow-up and data collection continue throughout the study, which concludes in 2029, ensuring thorough evaluation of this tailored treatment approach.

Researchers are evaluating how to best recommend chemotherapy for patients with Stage IIB, IIC, or Stage III colon cancer based on the presence or absence of circulating tumor DNA ctDNA after surgery. This Phase IIIII trial explores whether ctDNA status can help guide decisions about the need for adjuvant chemotherapy and identify the optimal chemotherapy regimen for those at high risk of recurrence. Circulating tumor DNA is a promising biomarker that may detect microscopic residual cancer cells that traditional methods might miss. Participants are assigned to groups based on their ctDNA results after surgery. Those without detectable ctDNA ctDNA- may undergo serial monitoring without treatment or receive different chemotherapy regimens such as mFOLFOX6 or CAPOX for 3 to 6 months. Patients with detectable ctDNA ctDNA who have a higher risk of recurrence are randomized to receive either standard chemotherapy regimens like mFOLFOX6 or CAPOX for 6 months or a more intensive regimen called mFOLFIRINOX for 6 months. Central ctDNA testing is performed using the Signatera test to guide these assignments. During the study, participants have blood samples collected for ctDNA testing and undergo imaging scans to check for cancer recurrence. Researchers assess disease-free survival, overall survival, and chemotherapy compliance over several years. The study includes monitoring for safety and treatment effects, with follow-up planned for up to 5 years after randomization. Participants health status, laboratory tests, and tumor markers are regularly evaluated throughout the treatment and follow-up periods.

Researchers are evaluating the effects of a medicine called BI 690517 combined with empagliflozin in adults with chronic kidney disease CKD who are at risk of their kidney condition getting worse. The study includes people with or without type 2 diabetes and those who may already be taking medicines like angiotensin converting enzyme inhibitors ACEi, angiotensin receptor blockers ARB, or sodium-glucose cotransporter-2 inhibitors SGLT2i. The goal is to understand if adding BI 690517 can help delay worsening kidney function, hospitalizations due to heart failure, or cardiovascular death. After a run-in period where all participants take empagliflozin and other standard medications, participants are randomly assigned to receive either BI 690517 tablets or placebo tablets once daily alongside empagliflozin. The run-in period confirms that participants are stabilized on empagliflozin before randomization. The treatment phase continues for about three to four years until enough kidney or heart-related events have occurred to compare outcomes between the two groups. During the study, participants visit the study site about five times in the first six months and then every six months thereafter. At these visits, health is regularly checked through blood and urine tests, blood pressure and weight measurements, kidney function monitoring, and collection of any side effect information. The main outcome measured is the time until the first occurrence of kidney disease progression, hospitalization for heart failure, or cardiovascular death.

Researchers are investigating whether patients involved in cancer clinical trials are willing to provide information about their social, economic, and environmental factors, known as social determinants of health. These factors include income, education, employment, housing, social supports, and experiences related to discrimination or stress. The goal is to better understand barriers to clinical trial participation and access to healthcare. Participants will be asked to complete a standardized Social Determinants of Health SDoH Questionnaire in English or French. This questionnaire covers non-medical aspects that influence health, including the environments where participants live, work, learn, and play. The study aims to assess the feasibility and acceptability of collecting this sociodemographic data from adults involved in Canadian Cancer Trials Group studies. Participation involves filling out the questionnaire, which takes about 10 minutes or less. Researchers will analyze responses to evaluate how practical it is to gather this information and how comfortable participants feel about answering these questions. The study will help inform future efforts to improve understanding of who participates in cancer clinical trials and the challenges they face. The study is planned to run from May 2026 to June 2027.

Researchers are studying women with low-risk ductal carcinoma in situ DCIS to determine if breast radiation therapy can be safely avoided after breast conserving surgery. The study evaluates whether combining clinicopathological factors with the Oncotype DX DCIS score can identify those at very low risk of local recurrence. This prospective cohort study is conducted in Canada and aims to improve treatment decisions for women with DCIS. Participants will have their tumour tissue sent to Exact Sciences for DCIS score analysis. Those with a score predicting a 10-year local recurrence risk of 10% or less will be enrolled and followed without radiation therapy. The study will document surgery details, tumour characteristics, and patient health status using established criteria. Enrollment involves a two-step registration process through a web-based system. During the study, participants will be followed annually for up to 10 years with yearly breast exams and bilateral mammograms to monitor for recurrence. Data on patient demographics, tumour features, and outcomes will be collected and verified. The main outcome measured is the rate of local recurrence in the treated breast after five years, along with secondary measures such as invasive recurrence, disease-free survival, and overall survival.

This research aims to evaluate the omission of adjuvant whole breast radiation therapy in women with breast cancer who have no clinical evidence of lymph node involvement and have achieved a pathological complete response after neoadjuvant chemotherapy. The study focuses on female patients with newly diagnosed T1-3 node negative breast cancer treated with breast conserving surgery and axillary staging surgery, without distant metastatic disease. The goal is to understand the impact of skipping radiation therapy on breast cancer outcomes. Participants will not receive the usual adjuvant whole breast radiation therapy following breast conserving surgery. Instead, they will be followed over time to monitor their health status. The study is designed as a single arm cohort, meaning all enrolled women who meet the criteria will be observed without receiving radiation therapy. The first analysis is planned after a median follow-up of 5 years. Throughout the study, participants will undergo regular assessments to check for local, regional, and distant recurrence of breast cancer, as well as disease-free survival and overall survival. Any additional breast cancer treatments received after recurrence, such as repeat surgery, systemic therapy, or radiation, will be documented. The total participation duration is planned to extend up to 5 years, with ongoing monitoring to measure outcomes and safety.

This research aims to compare two targeted radiotherapy approaches for patients with brain metastases who have a poor prognosis. The study evaluates whether a single high dose of 8 Gy given in one treatment session is not worse than the standard approach of 20 Gy delivered over five sessions in terms of overall survival. The goal is to find a simpler, faster treatment option that maintains survival outcomes for these patients. Participants will be randomly assigned to receive one of two treatments either five sessions of 4 Gy each using volumetric modulated arc therapy on a conventional linear accelerator or a single session of 8 Gy using the same technology and setup. Both treatments target brain metastases specifically without using stereotactic radiosurgery techniques. The study includes follow-up imaging and monitoring to track disease control and treatment effects. During the trial, participants will undergo regular assessments including brain imaging, performance status evaluations, corticosteroid use monitoring, and quality of life questionnaires. The study will measure overall survival over one year, along with secondary outcomes such as time to decline in performance status, control of brain metastases, need for retreatments, adverse events, and health-related quality of life. Participants will be followed for up to one year to evaluate these outcomes and safety.

The trial investigates the impact of a laboratory test overuse intervention bundle on reducing unnecessary lab tests among adult hospitalized medical patients in 16 hospitals across British Columbia. This stepped-wedge cluster randomized study aims to assess whether educational and patient engagement tools can effectively decrease overuse of routine lab tests such as complete blood count, electrolytes, creatinine, and coagulation tests. The study addresses concerns like patient discomfort, sleep disruption, and hospital-acquired anemia caused by excess testing. The intervention group will receive a bundle including online educational modules, clinical decision support tools, audit and feedback reports for healthcare providers, and patient engagement materials like videos and infographics. Local hospital teams will adapt and implement these tools over sequential 12-week steps, with an initial 4-week period for piloting and adapting tools followed by 8 weeks of active intervention. The control periods involve usual care without the intervention tools. Participants include hospitalized adult general medical patients under internal or family medicine care, their attending physicians, learners, and allied health staff involved in ordering tests. Researchers will collect data for at least 24 weeks after implementation to evaluate changes in laboratory test utilization, readmission rates, mortality, and related costs. The study uses monitoring of test ordering patterns, readiness assessments, and workflow observations to measure impact and sustainability without dedicated personnel support.