Prince George

Researchers are conducting a phase III multi-institutional randomized trial to study patients with metastatic tumors who have up to 10 oligometastases and a synchronous primary tumor. The trial compares the current standard of care treatment with the standard of care plus Stereotactic Ablative Radiotherapy (SABR) to known disease sites. Patients are grouped based on cancer histology and the number of metastases to better understand outcomes. Participants are randomly assigned in a 1:2 ratio to receive either standard palliative radiotherapy or standard care combined with SABR. The standard treatment includes various therapies like chemotherapy, hormone therapy, immunotherapy, targeted systemic therapy, observation, and palliative radiotherapy with recommended dose schedules. SABR dosing options include 20 Gy in 1 fraction, 30 Gy in 3 fractions every other day, or 35 Gy in 5 daily fractions. Other local treatments, such as surgery, radiofrequency therapy, or fractionated radiation, may also be used based on clinical judgment. During the study, patients undergo restaging imaging within 12 weeks before randomization and are monitored for overall survival up to approximately 6 years. Assessments include evaluating the number and size of metastases, performance status, and medical history to ensure safety and eligibility. The study carefully monitors for complications related to radiotherapy and other treatments, with follow-up visits structured to assess patient outcomes and treatment effects over time.

This trial investigates the effectiveness of Pumitamig compared to Pembrolizumab in adults with advanced Non-Small Cell Lung Cancer (NSCLC) who have not received prior treatment and whose tumors express PD-L1 at 50% or higher. The study targets individuals with locally advanced or metastatic NSCLC, focusing on those with measurable disease and good performance status. It is a Phase 3 randomized, double-blind study designed to compare these two treatments as first-line options for this patient group. Participants will receive either Pumitamig or Pembrolizumab at specified doses on scheduled days. The treatments are given as monotherapy, meaning each participant receives only one of these drugs throughout the study. The study does not mention additional treatment phases or extensions, focusing on the direct comparison of these two drugs for initial treatment. Throughout the study, researchers will assess how long participants live without their cancer worsening, using standardized criteria over about three years. Overall survival will also be tracked for up to five years. Participants will be monitored regularly to evaluate their response to treatment and overall health. Safety and effectiveness outcomes will be gathered through medical assessments consistent with clinical trial standards for NSCLC.

Researchers are studying tailored adjuvant treatments in women with early-stage endometrial cancer, focusing on two specific molecular types: POLE-mutated and p53 wildtype/no specific molecular profile (NSMP). This phase II study aims to compare a new, less intense treatment approach against the usual care, which typically involves surgery followed by additional therapies like radiation or chemotherapy based on pathology results. Participants receive treatment after surgery, which includes hysterectomy and removal of ovaries and fallopian tubes. The study involves two sub-studies: one for POLE-mutated cancer patients and another for those with p53 wildtype/NSMP cancer. Treatment may include vaginal brachytherapy using a vaginal cylinder or ovoids, or external beam radiotherapy (EBRT) with or without brachytherapy, delivered with specialized radiation equipment. Some patients may be placed under observation without additional radiation. During the study, participants are closely monitored with follow-up visits to assess treatment effects and check for cancer recurrence, particularly pelvic recurrence over three years. Researchers collect patient-reported outcomes through questionnaires in English, French, or other validated languages. The study tracks safety and effectiveness over time, requiring participants to be accessible for treatment and follow-up at the study centers, with treatment starting within ten weeks after surgery.

Researchers are evaluating whether two new immunotherapy drugs, botensilimab and balstilimab, can help patients with colorectal cancer that cannot be removed by surgery and is resistant to treatment. The study compares these drugs to the usual supportive care provided to improve quality of life. It also aims to see if these treatments slow tumor growth, shrink tumors, and identify markers in tumors or blood that predict benefits. Safety and how long the body takes to process these drugs are also being studied. Participants will receive either botensilimab and balstilimab or the best supportive care, which focuses on relieving symptoms and improving quality of life. Botensilimab is given as an intravenous infusion at 75 mg every 6 weeks for 4 doses, while balstilimab is given as 450 mg intravenously every 3 weeks. Those receiving supportive care will get treatments to help manage symptoms but not the investigational drugs. During the study, participants will be monitored for overall survival over 34 months. Researchers will assess quality of life, tumor response, and look for biological markers in tissue and blood. Safety will be closely followed, and participants must be available for treatment, follow-up, and completing questionnaires in English or French. The total study duration and treatment timelines are structured to ensure thorough evaluation of outcomes and safety.

Researchers are evaluating how to best recommend chemotherapy for patients with colon cancer after surgery by using the presence or absence of circulating tumor DNA (ctDNA) in the blood. This approach aims to identify microscopic residual tumor cells and may provide better risk prediction for cancer recurrence compared to traditional methods. The trial focuses on patients with Stage IIB, IIC, or III colon cancer who have undergone complete tumor removal. Participants will have their tumor tissue and blood tested centrally using the Signatera assay to determine ctDNA status. Patients without detectable ctDNA may avoid chemotherapy, while those with detectable ctDNA are considered at higher risk and will be randomly assigned to receive different chemotherapy regimens, including mFOLFOX6, CAPOX, or mFOLFIRINOX, given intravenously or orally over periods ranging from 3 to 6 months. The study includes initial screening, treatment, and possible second randomization for patients whose ctDNA status changes during monitoring. During the study, participants will undergo various assessments including blood tests, imaging scans, and performance evaluations to monitor their health and response to therapy. Researchers will track the time to ctDNA positivity and disease-free survival for up to 3 and 5 years, respectively. Safety and treatment effects will be closely observed throughout the study duration, ensuring thorough follow-up and monitoring for all participants.

Researchers are investigating the effects of a medicine called BI 690517 in combination with empagliflozin for adults with chronic kidney disease who are at risk of their condition worsening. This study includes people both with and without type 2 diabetes and those already taking certain kidney-related medicines like ACE inhibitors or angiotensin receptor blockers. The goal is to understand if adding BI 690517 helps protect kidney function and reduces risks related to kidney failure and heart problems. This is a Phase 3 clinical trial conducted over about 3 to 4 years. The study has two parts. First, participants receive either empagliflozin or a placebo similar to BI 690517 for at least six weeks, while continuing other indicated treatments like ACE inhibitors or ARBs. In the second part, participants are randomly assigned to take either BI 690517 tablets or placebo tablets once daily alongside empagliflozin for the rest of the study. The placebo tablets look like BI 690517 but contain no active medicine. Participants have regular visits to the study site, about four times in the first six months, then every six months afterward. During these visits, doctors monitor kidney function, heart health, blood pressure, weight, and any side effects. Blood and urine samples are taken to track health changes. The main outcomes measured are the time until worsening kidney disease, hospitalization for heart failure, or cardiovascular death. The study ends when a certain number of these events have occurred.

Researchers are evaluating whether combining clinicopathological factors with the Oncotype DX DCIS score can help identify women with low-risk ductal carcinoma in situ (DCIS) who might avoid radiation therapy after breast conserving surgery (BCS). This prospective cohort study in Canada aims to find a group of women at very low risk of local recurrence following BCS, defined by a 10-year predicted risk of 10% or less according to the DCIS score. Women who meet the criteria will have their tumor tissue sent to Exact Sciences for the DCIS score analysis. About 809 women will be screened, and approximately 526 women with a low-risk DCIS score will be enrolled and followed. The study involves a two-step registration and enrollment process, with data collection on patient demographics, surgery details, tumor characteristics, and performance status. Participants will be followed annually for up to 10 years, including yearly bilateral mammograms and breast exams to monitor for local recurrence. The study will measure ipsilateral local recurrence as the primary outcome over a 5-year period. Data quality will be ensured through verification by source documentation, and results will be shared with treating physicians and the research group.

Researchers are evaluating the option of skipping radiation therapy after breast conserving surgery in women with breast cancer who have no cancer remaining in their breast or lymph nodes following chemotherapy before surgery. This study focuses on women with early-stage breast cancer (T1-3, node negative) who received neoadjuvant chemotherapy and achieved a complete pathological response. The goal is to understand if radiation therapy can be safely omitted in this specific group to reduce treatment burden. Participants will not receive the usual whole breast radiation therapy after surgery. Instead, they will be closely followed over time to monitor any cancer recurrence. The study is a single-arm, multi-center trial enrolling women who meet strict pathology criteria after surgery. The primary outcome measured is ipsilateral breast tumour recurrence at a median follow-up of 5 years. No experimental drugs or radiation treatments are given; the approach is to omit radiation when certain conditions are met. During the study, participants will undergo regular assessments to check for local, regional, or distant recurrence of breast cancer. Researchers will also document any additional treatments needed if cancer returns. Safety and survival outcomes will be tracked over a planned follow-up period of at least 5 years. The study aims to include 352 women and will collect detailed data on disease-free and overall survival alongside recurrence rates.

Researchers are evaluating a shorter, targeted radiotherapy treatment for adults with brain metastases who have a poor prognosis. This study compares a single-session radiotherapy dose of 8 Gy to the standard five-session dose of 20 Gy to see if the shorter treatment is not worse in terms of overall survival. The study is a randomized Phase II non-inferiority trial designed for patients with limited life expectancy and aims to improve quality of life while controlling brain metastases. Participants will receive targeted radiation therapy delivered using Volumetric Modulated Arc Therapy to all brain metastases. The study compares one group receiving 8 Gy in a single session to another group receiving 20 Gy over five sessions. Treatment must begin within 14 days of enrollment. The study uses stratification to balance key prognostic factors such as diagnosis-specific scores and cancer histology across groups. During the study, participants will have regular imaging follow-up and complete questionnaires like the EuroQOL (EQ-5D-5L). The primary outcome is overall survival measured at one year. Researchers will monitor safety and treatment effects, with the study including up to 100 patients aged 18 to 100 years. Participants must have adequate performance status and be able to comply with study procedures throughout the trial.

Researchers are investigating whether a laboratory test overuse intervention bundle can reduce unnecessary lab testing in hospitalized medical patients across 16 hospitals in British Columbia. This stepped-wedge cluster randomized trial focuses on adult general medical patients and healthcare providers, aiming to address issues caused by excessive testing, such as patient discomfort, sleep disruption, and hospital-acquired anemia. The study evaluates if educational and patient engagement tools can be successfully implemented to change testing practices. The intervention bundle includes educational materials like an online module, clinical decision support tools, lab utilization reports for healthcare providers, and patient engagement resources such as videos and infographics. Local hospital teams will adapt and deliver these tools during a pilot phase followed by sequential rollouts in clusters of hospitals over 12-week steps. The initial 4 weeks focus on trialing and adapting tools, followed by an 8-week intervention period deploying the bundle. Participants will be monitored during and after implementation with data collected for at least 24 weeks post-intervention to assess lab test ordering patterns without dedicated personnel support. Researchers will review laboratory test usage, focusing on specific tests like complete blood count and electrolytes. Ongoing access to educational resources and lab utilization reports will support sustained changes. The total study duration extends from May 2024 to October 2026.