Clinical trials in prostate cancer expanded at Novant Health Zimmer Cancer Institute in Wilmington

Research studies are expanding the list of treatment opportunities for the nearly 3,500 cancer patients treated annually at Novant Health Zimmer Cancer Institute, located at Novant Health New Hanover Regional Medical Center. Michael Papagikos, MD, the Coastal market’s lead physician for the Cancer Institute, is spearheading research focused on prostate cancer to test the efficacy of certain treatments while expanding exceptional cancer care locally.

“My goal is to treat my patients with technologically advanced radiation therapy in an expert, compassionate and respectful manner, with the goal of improving and extending their life,” Papagikos said. “I believe that a commitment to offer patients the opportunity to participate in high-quality clinical research will improve cancer outcomes.”

As the institutional principal investigator for all genitourinary oncology studies in the Coastal region under nonprofit research organization NRG, Papagikos has been empowered to refer patients to multiple prostate cancer clinical trials and to publish extensively on the management of prostate cancer. His philosophy: All patients deserve access to high-quality clinical trials as part of their treatment journey.

Just this year, Papagikos co-authored research on prostate cancer through an international study with participants from the Cape Fear region. The study gathered data on the effectiveness of adding hormonal therapy to radiation therapy. Hormonal therapy, also called androgen deprivation therapy, has significant potential because it can greatly reduce levels of testosterone and other androgens that can stimulate the progression of prostate cancer.

Papagikos shared that, by adding a short course of testosterone-blocking medicine for patients who were already receiving high-dose radiation therapy, those patients experienced improved outcomes over radiation therapy alone. The research revealed a decreased likelihood of the cancer spreading to other areas of a patient’s body, as well as a decreased likelihood of that patient dying of prostate cancer. These findings could contribute to the ongoing decline in the death rate prostate cancer has seen since 1993.

“To put this study in context, we have known for decades that adding hormonal therapy to historically standard dose radiation for prostate cancer improved outcomes,” said Papagikos. “We then saw rapid improvements in our ability to improve the precision and accuracy of radiation therapy and the question arose, ‘Do we still need hormonal therapy when our radiation techniques and outcomes have improved so much?’ This study was done to answer that new question and the answer is yes. Importantly, we also wanted to know what the impact was on patients’ quality of life and, fortunately, the side effects of hormonal therapy were minimal, and by one year after treatment, there were no clinically meaningful differences in QOL between the two approaches.”

Papagikos also participated in a research study investigating the effect of brachytherapy with external beam radiation therapy compared to brachytherapy alone for select patients with intermediate-risk prostate cancer. The goal was to determine whether the combination of therapies would result in better freedom from progression versus brachytherapy on its own, which involves administering radioactive material inside the patient’s body. While the study showed no improvement from the combination of therapies, it did provide evidence that established brachytherapy alone as a safe standard treatment for intermediate-risk prostate cancer.

Novant Health’s participation in prostate cancer studies like these contributes to a global knowledge base of treatment options while helping effective treatments reach more patients. In addition, Wilmington-area patients are more easily able to access potentially lifesaving treatments that otherwise wouldn’t be available to them outside of clinical trials, Papagikos said.

Papagikos is also leading locally two newly opened trials for unfavorable intermediate risk and high-risk prostate cancer, attempting to personalize treatment through the use of advanced genomic classifiers that can provide much better patient-specific prognostic information.

Physicians like Papagikos at Novant Health’s New Hanover Regional Medical Center have been able to conduct and participate in more research, in part due to the partnership between Novant Health Zimmer Cancer Institute and UNC Lineberger Comprehensive Cancer Center, a National Cancer Institute-designated comprehensive center at the University of North Carolina at Chapel Hill. Not only does the partnership streamline opportunities for Novant Health oncologists who want to join clinical trials sponsored by the National Cancer Institute, pharmaceutical companies and medical device manufacturers, it strengthens ongoing Novant Health research by enabling joint projects with UNC.

Novant Health New Hanover Regional Medical Center oncologists are conducting studies in other therapeutic areas as well. One study is investigating the efficacy of hormone-blocking medications compared with short-term radiation for lower-risk breast cancer patients. An additional study is analyzing the benefits of commercially available, wearable health technology as a remote data collector for head and neck cancer patients. Novant Health oncology research is positioned to continue expanding in the coming year.

“I expect that over the next two years, we will have multiple clinical trials for different stages for all of our most common cancer types,” said Papagikos. “My hope is that every patient being seen by our highly skilled radiation, medical, gynecologic and surgical oncologists will not only be offered the best current standard of care treatment options but will also be offered the opportunity to participate in high-quality, impactful clinical trials.”