COMPPARE Consortium Spotlight: The Duke Cancer Center

Duke Cancer CenterThe Duke Cancer Center was designated as a comprehensive cancer center by the National Cancer Institute in 1973. In 2021, more than 66,000 patients received cancer care at Duke, and the Cancer Center received over $115 million in cancer research funding. The Department of Radiation Oncology at the Duke Cancer Center treated more than 2000 patients in 2021.

Duke has been one of the most active participants in the COMPPARE trial; the department is among the top 10 in accrual despite not having access to proton therapy. The institutional Principal Investigator, Professor of Radiation Oncology W. Robert Lee, MD, MS, MEd, attributed this success to a clinical research team that is committed to patient-centric care.

“Dr. Nancy Mendenhall asked me to participate in COMPPARE just prior to the beginning of the COVID-19 pandemic,” Dr. Lee stated. “I was keen to participate because I wanted to help with answering the question of whether proton therapy is superior. The pragmatic design of COMPPARE allowed me to do this without a proton machine.”

Accrual has increased recently at Duke and Dr. Lee hastened to credit two individuals for this improvement: Betsy Wells, MSN, ACNP-BC, a nurse practitioner who works with Dr. Lee caring for prostate cancer patients, and Heather Franklin, BSN, OCN, a clinical research nurse in the Department of Radiation Oncology.

“Prostate cancer patients are curious about proton therapy,” said Wells. “This is a way for them to be involved in answering important questions about how quality of life compares in patients treated with photons or protons.” Aside from the technical aspects, patient trust and open communication are critical to increased accrual. “Our patients trust Betsy to help guide them through treatment and listen to their concerns,” said Dr. Lee. “Betsy is involved early in the informed consent process and our accrual has improved as a result.”

The recent change to allow ultrahypofractionation on the COMPPARE trial has also helped with accrual at Duke. “Many men are enthusiastic about a shorter course of treatment,” said Franklin. “Before the change, many of these men were interested in participating in the trial but could not if they chose to be treated with ultrahypofractionation.”

Dr. Lee credited Franklin with aggressively screening potential patients in a proactive manner so that discussions about the COMPPARE trial occur early in the conversations about preferred treatment. Remote consent has also made a difference in accrual. “The recent move to a remote consent process saves patients a trip to Duke,” said Franklin. “Patients appreciate our commitment to making processes more convenient for them.” Wells agreed, and shared another patient-focused tip for increasing accrual: “I encourage patients to participate in the study by sharing that study participation is a way of helping others while contributing to medical research.”

Dr. Lee’s practice has been focused on the treatment of prostate cancer for three decades. “When I trained at the University of Florida, hypofractionation was considered a failure based on clinical reports from the 1970s and 80s. As our technologies have improved and rigorous trials comparing fractionation regimens have been reported, it is now clear that fewer, larger fractions are an alternative for men with prostate cancer. Patients are interested in shorter schedules, and we need to listen to them. The results of COMPPARE will add to what is known about fractionation in men with prostate cancer.”

Our COMPPARE Consortium Spotlight provides insight into the successes of our partner proton and photon centers across the U.S. We are grateful to Dr. Lee and his team for their input and dedicated participation in COMPPARE, and we appreciate all partner sites working so diligently to improve prostate cancer outcomes for men.