Scientists at Work: Hoosier Oncology Group
It was 1985. Ronald Reagan was in the White House. Gas cost about $1.20 per gallon. And a small group of young docs who had recently completed their fellowships in hematology/oncology at IU's medical school were talking about the fact that patients had to go to large, academic medical centers -- such as IU's Indianapolis-based campus -- to participate in clinical trials.
While huddled in the cafeteria at IU Hospital, the late Stephen Williams, Patrick Loehrer Sr. and Lawrence Einhorn agreed it was odd that only doctors in academic settings could enroll patients in clinical trials. At the time, doctors who chose to practice non-academic medicine rarely participated in the scientific testing of new drugs and treatment protocols.
"The notion was that clinical trials were done at the medical center -- period," said Loehrer, who completed his IU fellowship in 1983.
The trio set out to learn what physicians around the state thought about doing things differently: What if a network was created that provided clinical trial access to people closer to their homes instead of just in Indianapolis?
The IU oncologists quickly sold the idea to other physicians practicing around the state, including Rafat Ansari, Bill Fisher, Prasad Mantravadi, and Ken Pennington. With Williams, Loehrer, and Einhorn, the seven doctors founded a new clinical research organization.
They needed a name for the network. Loehrer, recalling the moment with a smile, suggested it be called the Hoosier Oncology Group, or HOG.
The name stuck. Originating within the Walther Cancer Institute, HOG's concept was simple: Doctors around the state could treat patients in their hometowns and HOG would collect the data centrally.
"It's been a journey in which we -- the community physicians and the academic physicians -- have worked together to create studies from the first inspiration to completion of the trial," Loehrer said. "We wrote the studies. We conducted the trials. It was such a different paradigm from the traditional cooperative groups in which the studies were written by one or two people and then sent down to people to participate or not participate. All of the physicians had skin in the game."
HOG celebrated its 25th anniversary with a gala on April 10. Since its inception, the group has helped enroll 3,000 patients in more than 120 clinical trials. HOG currently is conducting clinical trials at 17 sites in Indiana and is a partner with the Indiana University Melvin and Bren Simon Cancer Center.
"If you are diagnosed with cancer in Indiana, you are in good hands wherever you are because a clinical trial is probably very near you," said Quake Pletcher, HOG's executive director.
Complementing its core mission, HOG also administers research beyond the state's boundaries. HOG trials are open in 50 sites across the nation and in Lima, Peru, and London.
That it brings cancer research close to home for patients makes HOG unique among other clinical research organizations.
HOG trials have helped alter the standards of cancer care. HOG doctors have assisted in evaluating complex treatment protocols. HOG clinical trial research has shown that sometimes, complex protocols are no better than simpler therapies -- and may even be worse, since cancer therapies often involve the administration of mildly toxic chemicals. For example, care for lung cancer patients changed as it was discovered -- with the help of HOG physicians -- that "maintenance" therapy following initial therapy was often unnecessary.
HOG trials have also shown toxicity for patients could be reduced by using a fewer chemical agents. Other trials have revealed how treatment protocols can be modified to minimize side effects.
Despite the progress and successes, Loehrer said there is more to do.
"Until we get to the point at which all cancers -- like testicular cancer or Hodgkin disease, are either cured or prevented -- we can't rest," he said. "Until that day, our collaborative partnership with patients, physicians and scientists must be focused on diligently discovering new treatments."
For more information about HOG, please visit http://www.hoosieroncologygroup.org/.