Queen s University Department of Oncology Strategic Research Plan 2014-2018
Department of Oncology, Queen s University Five Year Strategic Research Plan 2014-2018 TABLE OF CONTENTS Executive Summary... A. Introduction... B. Purpose... C. Process of Strategic Plan Development... D. Principles to inform priority setting... E. Strategic Research Priorities 2014-2018... 1. Patient Oriented Research 2. Population and Health Services Research 3. Innovation in Care Delivery 4. Molecular Oncology and Translational Research 5. Radiation Physics Research Page 1 of 17
F. Summary Department of Oncology Strategic Research Plan G. Appendix I Environmental Scan... 1. School of Medicine Plan 2. Queen s University research Strategy 3. National/Provincial research Priorities 4. Department of Oncology Research activity of primary appointees H. Appendix II Department Survey... Executive Summary In 2013 the Department of Oncology embarked on a process to develop a Strategic Research Plan. The purpose of the plan is to build on existing research strengths and target key areas for future growth through guiding new investment and focussing recruitment priorities, developing interdepartmental interest groups and identifying competitive sources of new funding. The process of strategy development was led by the Department of Oncology Research Advisory Committee and was completed through a day long retreat for Faculty. The plan was guided by a number of principles. These included alignment with the Queen s University and the Faculty of Health Sciences Research Strategies, fostering increased research opportunities for Department of Oncology faculty who are not primarily based at the Queen s Cancer Research Institute, and building opportunities for interdisciplinary collaboration and engagement of patients. Five strategic priorities were identified as follows: 1. Patient Oriented Research 2. Population and Health Services Research 3. Innovation in Care Delivery 4. Molecular Oncology and Translational Research Page 2 of 17
5. Radiation Physics Research Department of Oncology Strategic Research Plan These themes each have specific actions associated with them and will be supported by targeted investment through competitive competition(s). The impact of the strategy and progress towards the goals articulated in this plan will be monitored by the Research Advisory Committee and reported annually to the members of the Department of Oncology and Faculty of Health Sciences. Page 3 of 17
A. Introduction The Department of Oncology faculty have a long standing commitment to research that spans from laboratory based studies through to clinical and population research. In 2012 the Department tasked its Research Advisory Committee to develop a strategic research plan. The purpose of this work was to bring together all Department members around a common set of goals and priorities. This 5-year strategic roadmap will chart a course for growth and investment of our research mandate and will yield improvements in patient outcomes. B. Purpose: The purpose of the Department of Oncology strategic research plan will be to build on existing research strengths and target key areas for future growth through: guiding new investment (through internal cancer research competitions and other) focussing recruitment priorities establishing and enabling activities of a research coordinating office in department developing interdepartmental interest groups identifying competitive sources of new funding C. Process that was followed: This plan was developed based on multiple inputs from within and outside the Department of Oncology including: Environmental scan: The RAC reviewed relevant local and provincial/national strategic documents (e.g. OICR, CIHR) and information on current Department research activities (Appendix I) Stakeholder engagement : A survey of department members and other key stakeholders on potential new research directions was completed (Summarized in Appendix II) Page 4 of 17
RAC brainstorming: Based on the above inputs, key strategic areas for Departmental focus were defined. As well, enablers including the investment needed to develop these were described Departmental Review: Discussion of the DRAFT strategic plan content and recommendations were presented and discussed at a Department retreat Incorporation of retreat feedback into the plan D. Principles The following principles were developed to guide the development of this plan: 1. The plan must align with Queen s University and the Faculty of Health Sciences Research Strategies (see Appendix I) 2. The plan will build on existing research strengths 3. The plan will encourage: a. Increased research opportunities for Department of Oncology faculty who are not primarily based at the Queen s Cancer Research Institute b. Increased interdisciplinary collaboration within faculty, across university and with external institutions c. Research that engages patients treated at KGH and local partner institutions 4. The plan should lead to an increase in applications to new provincial, national or international research funding opportunities and reflect important new directions in cancer medicine and practice E. Strategic Research Priorities 2014-2018: The following priorities are identified. Each includes a series of goals and/or action items. Each priority will require individuals, teams, or steering groups to push the agenda forward. 1. Patient Oriented Research: This theme is one that was highlighted as being a key strategic priority for the Department of Oncology. It builds on current strengths, reflects a priority area for external funders (CPAC, OICR, CIHR) and Faculty of Health Sciences strategic framework. Page 5 of 17
Under this strategic theme are 3 different items: Department of Oncology Strategic Research Plan a) Cancer Clinical Trials at the Cancer Centre of Southeastern Ontario: It is recognized that a number of changes will be required to enhance the Department s Patient Oriented Research. These include: increasing the portfolio of radiation oncology trials, improvement in the accountability of study investigators to promote and recruit to open studies, developing better tools to estimate feasibility, and improving the efficiency with which trials are opened and how potential eligible patients are identified. Furthermore, there is an increasing interest in supporting local clinical research activities [see b) below] The following are the strategic goals for the next five years. Achievement of these goals will be the priority of the Co- Directors of Cancer Clinical Trials at CCSEO: I. Based on best evidence, a robust, innovative business and operational model will be created for support of trials in the Department and Cancer Centre. This will include requests for stable support from the KGH Foundation along with improvements in trial recruitment, forecasting and enhanced efficiencies in trial activation. New models of trial conduct will create a positive environment to facilitate and gain commitment for clinical trial accrual II. Participate in Canadian Cancer Clinical Trials Network by becoming a Network Affiliated Cancer Centre of CCCTN III. Enhance recruitment to a portfolio of trials that will combine both high accruing and molecular defined tumour groups IV. Make explicit the expectation that all clinical faculty contribute to clinical trial recruitment V. The above work will yield the following important metrics: A doubling of recruitment to academic (cooperative group) trials by 2017 years A balanced budget for trials unit achieved by 2014/15 b) Local clinical and patient studies: There is a need to increase the number of clinical research activities within the Department, beyond those of formal external sponsored clinical trials. These could include studies aimed at gauging patient input into trials endpoints, local clinical studies, quality of life, palliative care questions and more. Such research opportunities could be supported by local competitions or other sources and their data management supported by the staff in the local Clinical Trials Unit. Page 6 of 17
The following are the goals of this priority over the next five years: I. Support the development of local patient studies within the cancer program through targeted competitions on an annual or bi-annual basis. II. Utilize this activity as an opportunity for local fundraising and for career development of Faculty within the Department c) NCIC Clinical Trials Group Queen s University is home to the national statistical and operations office of the NCIC Clinical Trials Group. This national academic cooperative group conducts national and international phase I-III cancer trials that strive to improve the quality and quantity of survival in cancer patients. The Department is fortunate that several members of the NCIC CTG faculty have primary Department of Oncology appointments and furthermore, that several other members of the Department have held national leadership roles in NCIC CTG trials and committees. A substantial contribution to the overall Departmental research activity is NCIC CTG driven research (including the cancer clinical trials conducted at the CCSEO). Thus the continued success of the NCIC CTG is a strategic priority for the Department. In the next five years, the Department of Oncology will: I. Facilitate the recruitment and appointment of clinical CTG faculty II. Provide opportunities for career development of CTG faculty through clinical, educational and additional research activities III. Investigate opportunities for Department of Oncology clinical faculty to develop new roles within CTG 2. Population and Health Services Research This theme is one that was highlighted by many in department as being a key strategic priority for the Department of Oncology. Several department members are clinician scientists in this area as part of the Cancer Care Epidemiology (CCE) Division of the Queen s Cancer Research Institute. Several members of clinical faculty have highlighted their interest in having the resources and Page 7 of 17
expertise found at CCE more widely available to address questions posed by those individuals who have a primary clinical role in the Department. The challenge is that such research requires funding support for adequate methodology, statistical and other resources and each project must therefore be resourced by some means. Furthermore, each project requires not only a clinical question(s) whose answers may lie within the databases created at CCE, but there also needs to be adequate clinician researcher time for mentorship of those clinical faculty who may wish to become involved in these types of research questions. To facilitate access to the resources available through CCE, the following are proposed: I. Develop a plan for funding a half time analyst position over a two-year period dedicated to clinical member s research questions. Access to the analyst s time would be through a 6-monthly competitive application process. The Research Advisory Committee and investigators at CCE will provide oversight to this process. II. Develop an inventory of pre-existing databases and expertise at CCE. Investigators may already have created robust datasets which may be utilized for research questions beyond those addressed in the primary analysis. III. Designate the CCE Division Head (Dr. Michael Brundage) as a point person at CCE, with organizational assistance from Jennifer O Donnell, for those making first contact with CCE investigators. Connecting with CCE investigators early on will ensure that ideas are feasible. Jennifer will also be responsible for maintaining & disseminating the inventory of data and expertise available at CCE to the Department of Oncology. IV. It was also recommended that CCE consider expanding its radiotherapy data holdings. A proportion of the analyst position described above could be dedicated to this task. The feasibility and strategic value of expanding the data holdings will be discussed internally at CCE. 3. Innovation in Care Delivery The delivery of cancer care in Ontario is currently undergoing a transformation. Cancer Care Ontario (CCO) is placing greater emphasis on the provision of patient centered models of care across the system. Although large co-operative group trials are important, often smaller single centre studies can provide faster, and more tailored information for specific questions. Opportunities exist to provide clarity on the best way to provide patient centered care by engaging current patients and family Page 8 of 17
members to drive improvement by conducting local needs assessment studies and clinical trials. We also have the opportunity to assess the economic and patient experience impact of care delivery interventions at our cancer center. Additionally, and of particular interest to both clinicians and patients, there is the question of how and when are services offered/asked for/received by patients? Finally, there are opportunities to collaborate with the Patient Oriented Research activities of the cancer centre. Improving our ties with CCO may also allow for future collaborations in which CCSEO may play key roles in defining the future of cancer care in Ontario. Although it is not hard to see the potential benefits of including Innovation in Care Delivery as a key strategic priority for the Department of Oncology there remain challenges to overcome, not least of which is funding. The innovative use of existing information (such as ESAS data), as well as learning more about our patient population in order to better conduct research that is meaningful and beneficial for the most patients possible is critical in a fiscally conservative environment. Improving access to local and national leaders in patient centred research, as well as increasing access to research support will be key measures in improving research and patient care at KGH. Infrastructure and stewardship will need to be addressed if this strategic priority is to go forward. To facilitate the development of this priority research area, the following actions are proposed I. Integrate our strategy with the current provincial and national initiatives implemented by Cancer Care Ontario and the Canadian Cancer Society initiatives. II. Engagement and collaboration with a number of different researchers and groups, including: a. Researchers with shared interests in the Division of Cancer Care and Epidemiology, Department of Public Health Science and the School of Nursing. b. Patient educators in both the CCSEO and the KGH to collaborate on designing best practice education interventions for patients and families across all phases of the cancer care continuum. c. Patient and family advisory group members to help to define research questions. III. Take advantage of current data holdings (such as in-house ESAS and Picker data held at ICES) to implement studies designed to extract maximal value from the information contained in the data bases. Page 9 of 17
Funding to support research in this section could include not only local sources but also a Canadian Cancer Society Research Institute Impact Grant, once the research questions are developed and refined. 4. Molecular Oncology and Translational Research Molecular oncology is an area of emerging importance and interest for members of the Department of Oncology and also members of the Department of Pathology/Molecular Medicine and Queen s Cancer Research Institute. A key priority for the Cancer Centre and Hospital over the next 5 years is to develop a strategic plan for implementing personalized (i.e. molecular genomic directed) cancer care, the research required to guide this plan and to measure its success. A Molecular Oncology Working Group with members from the two Departments and QCRI has been established and identified two key questions: What contributions should we and could we be making at Queen s? Are there specific cancer types where local expertise makes a natural focus possible? The Molecular Oncology working group identified several tumour types where local expertise and early collaborative relationships have been built. This plus the availability of next generation sequencing technologies provide a foundation that can be brought together into streams of novel research. The following actions are recommended: I. The Molecular Oncology working group will be formally structured as a committee to develop this area II. The group will perform additional strategic planning, including A more in-depth strengths, weaknesses, opportunities and threats (SWOT) analysis in Molecular Oncology Identification of three to four molecular oncology research themes with appropriate local patient cohorts and promising funding opportunities. For each theme, a smaller team will be created that will delineate research and funding goals along with specific timelines. Page 10 of 17
III. IV. Department of Oncology Strategic Research Plan The Department will consider special local funding competitions utilizing Foundation funds to support this work with the expectation that successful projects will be competitive for larger scale peer reviewed funding. Through the above, a track record in molecular genetics tumour testing will be developed that will increase opportunities for cancer research at Queen s and will also increase our competitiveness in the field of molecular diagnostic service delivery. 5. Radiation Physics The Cancer Centre of Southeastern Ontario at the KGH has been providing cancer treatment to the population of Southeastern Ontario for over 80 years since its inception in 1933 as Ontario s first radiotherapy clinic. As the clinic was established, it made many notable innovations; one of the most interesting developments was the recruitment of a fulltime medical physicist, Art Holloway, in 1948. Today the Department of Medical Physics serves Southeastern Ontario through clinical, research and educational activities. The research efforts of the department have proceeded at two levels: Basic fundamental research in radiation dosimetry in particular three-dimensional radiation dosimetry for advanced radiation treatment validation and the clinical extension of image guided radiation therapy to Cobalt-60 treatment units. In the last decade, our fundamental research enabled medical physicists to advance their expertise to areas of radiation delivery such as intensity modulated treatment, image guidance with cone beam computed tomography, advanced treatment planning, etc. - often before commercial clinical tools for such work were available in the cancer centre. This work has benefited considerably from the effort of Queen s graduate students and post-doctoral fellows primarily supported through peer reviewed national and provincial research competitions. Clinical developmental work intended to implement and introduce new treatment techniques into the clinic as appropriate radiation devices and associated tools were delivered to Kingston. This applied clinical research has included the development of software dose plan evaluation tools, the investigation of brachytherapy quality assurance techniques, the comparison and evaluation of various dosimetry techniques for the validation of specific treatment plans individual patient, etc. This work has been typically undertaken by departmental staff supported by small local and industrial grants. The departmental strategy as we move forward will be to maintain both these research areas as follows: Page 11 of 17
The established basic research will continue with collaborators at Queen s, and across the province, country and globe. Active participation will continue in Cancer Care Ontario medical physics research initiatives and in research collaborations such as the Ontario Consortium for Adaptive Interventions in Oncology (OCAIRO). One important goal in sustaining the basic research efforts of the department will be to mentor staff so they can also take on roles of principal investigators in peer reviewed research. The clinical developmental work has benefited considerably from the recent acquisition of a number of advanced treatment delivery systems (linear accelerators, computed tomography simulators, advanced high dose rate brachytherapy units and axillary treatment planning systems). An important goal of the clinical development research activity will be to extend the research work to multidisciplinary teams involving oncologists and therapists. Communication between and within the various research groups (staff in Medical Physics and collaborators, potential participants, Clinical Trials, etc.) will be strengthened through regular advertised research meetings. All project, program and working groups will be encouraged to actively report and these meetings. The efforts of the Medical Physics Department KGH s Cancer program have always been directed to serving the population of Southeastern Ontario. Our research efforts ensure that this service also extends to the region s future population. F. Summary This plan for research in the Department of Oncology has identified five thematic areas for growth and investment of time, people and resources. This plan is considered a living document not all of the priorities identified may be achievable and as new opportunities arise, new priorities may be identified. The Department will monitor the success of this plan through annual meetings, reports and retreats as needed. Page 12 of 17
G. APPENDIX I - Environmental Scan 1. School of Medicine Plan (http://meds.queensu.ca/templates/medicine/assets/medicine-strategic-plan-r20120622.pdf) Research priorities are primarily around increasing competitive success, increasing research capacity and establishing value propositions for various research investments. Oncology-relevant areas of research strength and foundational strengths highlighted in the plan include: Molecular medicine, Cancer, Health Systems/services, Clinical, KT, Biomedical, Drug Development and Human Toxicology Near and Long term outcomes relevant to Dept. of Oncology include: Industry outreach program and increase in private sector funding investment Matching strategic local investment to funder priorities New clinician scientists (these are for SEAMO departments only but depending on the research interest of those recruited may impact cancer-research) Intra and Inter-faculty collaboration increased 2. Queen s University Plan Elements of Queen s Research Strategic plan relevant to Dept. of Oncology (http://www.queensu.ca/vpr/srp/srpmay2012final.pdf) Queen s research strategy is divided into two main areas Guiding and supporting the research enterprise and Thematic foci for research investment. In the former, the principles of the strategy are articulated and include excellence, support of the academic mission, innovation, integration amongst others. Selected key recommendations of relevance to the Department of Oncology include those relating to development and promotion of research leadership, review of mechanisms to support programs as well as: Innovation - Foster knowledge translation where the outcomes of our research can benefit society. We are committed to advancing innovation through knowledge translation, commercialization, and through the development of Innovation Park Page 13 of 17
Collaboration and Interdisciplinary Research Global Engagement and Internationalization Department of Oncology Strategic Research Plan - Develop greater institutional coordination for global engagement and internationalization. - Increase global engagement by developing and expanding international research collaborations, partnerships and international development work. Part 2 of the document identifies major research themes which contain clusters within them of emerging and core strengths. The presumption is that these themes/clusters will be those of greatest interest for new program and other investments by Queen s. Relevant to the Department of Oncology are themes 1, 3 and 4 which are respectively: Exploring human dimensions (clusters include Society, Culture and Human Behaviour and Human Health and Wellness where Cancer is cited as a strength), Creating, Discovering and Innovating (cluster of relevance to Oncology is Advanced technologies, which would include physics related technologies), and Securing safe and successful societies (where the cluster Democracy, economy and public policy is of relevance to population and health services research being conducted within the Department). 3. National/ Provincial Priority Areas: Based on a recent (August 2013) survey of 33 research funding agencies (government/not for profit and provincial/national) conducted by the Canadian Cancer Research Alliance, the following areas were highlighted as being priority areas for strategic investment (only national and Ontario agencies summarized): - Prevention - CCO, CCS - Environment and cancer - CRS - Quality of Life - CCS, CCO - Translational Research - TFRI - Personalized medicine CIHR ICR, OICR, (GC) - Cancer Stem Cells - GC - Discovery application GC - Therapeutics discovery for difficult diseases OICR - Health services research including screening, adoption and health care deliver: OICR, CCO - Prostate Ca PCC Page 14 of 17
- Breast Ca CBCF Department of Oncology Strategic Research Plan Other topics in which strategic investment planned: - Digitization of Data OICR - Clinical Trial Enrolment/support (CCCTN) CPAC, OICR, and others - Use of CPTP national cohort data - Prevention researchers CCS - Cancer researcher career support - CRS - Patient Oriented research (CIHR and provincial governments) 4. Department of Oncology - Research Activity of primary appointees The following Data and attached summaries were abstracted from Faculty of Health Sciences ANNUAL REPORT SUBMISSIONS. Thus information may be missing if not included on annual reports. Publications and Presentations (see attached word document) - between 2008-2012 inclusive, Primary Department of Oncology Appointees have authored or co-authored: 448 peer reviewed publications 15 non peer reviewed publications (this may be underestimate since such publications may not be recorded on annual reports) 20 books/chapters ~170 poster presentations/technical reports (again these may be under-reported on annual reports) And have given 292 invited lectures/presentations Grants and Contracts ACTIVE in calendar year 2012: 95 grants or contracts were held by PIs with primary appointments in Department of Oncology totalling > $34,000,000.00 received in the calendar year 2012. Page 15 of 17
Some of these represented peer reviewed grants held by Department members, some are contracts held by NCIC CTG or CCE Division of QCRI, some represent national clinical trials per case funding activity of local PIs in the cancer centre. CURRENT Research Themes: It is clear from the content of publications and research grants that current Departmental research activities may be grouped as follows: Cancer Clinical Trials, which includes: - NCIC CTG faculty and leadership of national studies - Other faculty who lead studies or are local PIs for multicentre studies. Some of this work is done in collaboration with CTG faculty. Population, Health Services/Delivery and Patient reported outcomes research which includes: - CCE faculty and leadership - Other faculty who lead or initiate projects in the fields of outcomes research, innovations in clinical care delivery (e.g. colorectal cancer pilot project). Some of this work is done in collaboration with CCE faculty. Translational/Biomarker research - This theme includes activities that are largely, but not entirely, related to activities that tie in with NCIC CTG study-related opportunities for correlative sciences. In addition, there are some collaborations with non-ctg Department of Oncology Faculty and members of the Department of Pathology and Molecular Medicine that are noteworthy. Radiation Therapy and Physics: - Polymer Gel Dosimetry research - Techniques and research into delivery of modern radiation therapy utilizing Cobalt 60 source - HDR brachytherapy Page 16 of 17
H. APPENDIX II Survey Results: A questionnaire sent to all Department members (Primary and Cross appointed) to seek their advice regarding the top two areas for research to include in strategic plan. There was a relatively low response rate (8 responses representing 13 faculty one response included consensus recommendations from 5 medical physics faculty). Other responses were from the following faculty: medical oncology 3, radiation oncology 1, pathology and molecular medicine - 2, otolaryngology 1. The following areas were identified as ones which should be of high interest/priority in the plan: Molecular oncology (4), population studies including health services (4), clinical trials and in-house studies (5), and one each of the following: QoL/survivorship research, clinical technical development, fundamental and basic medical physics. Page 17 of 17