My name is Julien Donnelier. I’m the clinical research manager at the Prostate Cancer Centre. I’ve been the manager for about a year and three months. I’m originally from France, and my background is in neuroscience. My focus in clinical research has spanned many fields from dermatology, psychiatry, dental medicine, and now oncology.
Your role at the Prostate Cancer Centre, how would you describe your day to day?
Julien: As the clinical research manager, I make sure that daily operations are going smoothly. Daily, we see patients for various clinical trials. We have to coordinate those patients to come, see doctors, see coordinators, go for medical imaging. That’s the people management side of it, where I make sure that my team has whatever they need to do their job. Then my own job would be to bring on more studies, the negotiation, and the partnership with sponsors and pharmaceutical companies to get new trials, and to expand our activities.
How does the research process function for the Prostate Cancer Centre?
Julien: It’s a bit of a tricky question to answer. I would say the research starts with addressing a gap in the community. Either in treatment or in the community, whether its a disease that is not being treated properly or a diagnostic tool that doesn’t exist. It always starts by addressing an issue. And then once that happens, there’s a research proposal. Figuring out questions like “How are we going to answer this problem?” Those individuals involved will meet and come up with the best way to address this issue. To show how these patients are not currently being treated, and how we’re going to treat them. From there, we come up with a research proposal and find funding. What follows is the clinical trial where you must test your project. For example, if you proposed a new medication, you would test its effectiveness in comparison to an equivalent treatment, a placebo, or nothing. This is the time where we enroll patients to be part of a randomized study. From the study, we get data to see if people are doing better on the treatment compared to the regular standard of care. In oncology, it takes a long time. It can take 5 to 6 years. I’ve seen trials last as long as 10 years because cancer can last for a long time. Oftentimes, the endpoint that studies will look at are survival. We wait and see if we managed to extend the patient’s life or improve the quality of life.
You talk about gaps. From what you know about prostate cancer, do you see any obvious gaps? Or are these gaps becoming smaller, and, like you said, it’s about improving quality of life?
Julien: It goes in both ways because as clinical trials happen, we close some gaps while also discovering new ones, a new subtype of cancer or subtype of population. For example, you might not respond the same way as your neighbor and that poses a question. Why are you not responding the same as someone else with the same condition? So those clinical trials address the gap by providing new treatments to some populations, new diagnostic tools, but it also brings up new questions. Questions that need to be asked and addressed.
How many trials and studies are the Prostate Cancer Centre currently involved in?
Julien: The Prostate Cancer Centre is involved in a wide variety of trials. We have about 30 trials now. In terms of trial types, we have international clinical trials. These are sponsored by pharmaceutical companies trying to prove that their drug is working better than currently existing drugs or treatment is nonexistent. We have observational trials where it is an already approved drug and then we follow those people to make sure the drug is safe. Once a drug has been approved it’s released on the market, and they’ll still follow those people to make sure that nothing’s happened 10 years later. We’re involved in some registries where basically we just collect regular day-to-day data from people in the hope that in the future, it will tell us something about their cancer. So basically, we know they have cancer. We’ll follow them every 3 months and ask them about lifestyle questions, sleep habits, smoking habits, etc., in the hope that it will give us an idea of why those people are getting cancer. The more data, the better. We have research with Dr. Tarek Bismar, an expert in urological pathology, that is heavily involved in genomics. Prostate cancer is a wide term, you have several subcategories of prostate cancer. Those subcategories get treated differently. Then finally, we have some trials that are physician-initiated. These are more local trials trying to see what’s happening in Alberta.
How are your research findings translated into standard treatment for the patient?
Julien: This is a bit of a long process because once trials are completed, these findings are submitted to government agencies for approval. Once that goes through approval, the drug is approved for a specific indication. Since the trials are very specific, the drug is released for this subgroup. What often happens is if the success of that drug for this subgroup is significant enough, they’ll conduct more trials on other subgroups, and so, all other subgroups slowly get added to the population that can access it.
Locally, our impact extends beyond just providing treatments; we serve as a beacon of hope for men across Alberta facing prostate cancer. By offering access to drugs that haven’t yet received approval, we offer a lifeline to patients who may have exhausted conventional options. Our commitment to pioneering research ensures that these individuals have access to cutting-edge therapies that could potentially extend and improve their quality of life. Often, patients can only be on certain drugs for so long until it stops being effective. There’s a certain number of drugs that we can try sequentially, and clinical trials bring new options for them. Globally, the benefit of the Prostate Cancer Centre is that we are often one of the top recruiters in the world for internal clinical trials. Our contributions to these trials not only enhance our understanding of the disease but also pave the way for more effective therapies on a global scale. We’re bringing a lot of data into those clinical trials, contributing to the international knowledge of prostate cancer and treatments. As one of the top recruiters, we are one of the main reasons why these trials are successful.