Gary I. Cohen, MD, FACP, is the Medical Director of the Sandra & Malcolm Berman Cancer Institute at the Greater Baltimore Medical Center (GBMC). He is also the GBMC Director of the Johns Hopkins Clinical Research Network and holds an appointment as an Assistant Professor in the Department of Oncology at the Johns Hopkins University. Dr. Cohen is active with the Eastern Cooperative Oncology Group (ECOG) where he chairs the Community Scientific Committee and is the Community Co-Chair of the ECOG Melanoma Committee. Dr. Cohen is also a leader at the American Society of Clinical Oncology (ASCO) where he has volunteered on numerous committees and is currently a member of the ASCO Board of Directors.
When did research become a part of your career?
Research has always been a part of my career- it helped me become a better physician and provides a more rewarding professional life.
How did you decide to make research part of your career?
My career started at the Dana Farber Cancer Institute where I thought I would stay and do basic and clinical research. But I realized that I enjoyed seeing patients more. I decided to relocate from the Farber to a community setting where I could focus specifically on patient care and incorporate clinical research. Conducting clinical research in a community setting is the perfect opportunity to merge the benefits of the academic and private practice settings.
What was your fellowship experience and how did that translate into you becoming a community-based investigator?
I’d say that most fellowships do not prepare physicians well for careers in community-based research. A lot of physicians have to re-educate themselves when they enter the community setting. Fortunately there are a lot of resources to help physicians acquire competence. The extra effort is well worth the time.
What specific resources do you recommend?
There are a number of resources available through NCI and ASCO. Some of the ASCO resources I’d recommend are:
I’d also suggest ASCO’s Conquer Cancer Foundation because it offers several grants and awards for funding clinical research and training oncologists, and ASCO’s patient education website Cancer.Net, which offers patient-friendly information about understanding and participating in clinical trials.
How is research incorporated into your practice?
Clinical trials are part of our culture and enable us to provide the best care to our patients. I try to have the opportunity for clinical trial participation available for most of the patients seen at my site—which means we need to have a lot of trials available. Clinical trials are inherently designed for specific subsets of patients so we open several trials for each diagnosis. To meet this need we offer trials sponsored by NCI, the pharmaceutical industry and investigator-initiated trials either from our own investigators or through a partnership with regional academic programs. Altogether, we usually maintain 55-60 active clinical trials for oncology patients.
However, if you are just starting out, I’d recommend focusing on one or two areas until you become proficient. It’s better to do a few trials well then to conduct a lot of trials poorly.
You established the Cancer Center at GMBC. Do you have any advice for someone establishing a new community-based research program?
I’d recommend becoming affiliated with an NCI mechanism. Options include affiliating with a NCI-designated site like a Community Clinical Oncology Program (CCOP), joining a NCI-funded Cooperative Group, or conducting trials through the Clinical Trials Support Unit (CTSU). Clinical trials sponsored by the pharmaceutical industry are typically more difficult to break into. Most pharmaceutical companies look for sites that have already demonstrated competence. If you are still establishing the reputation of your site, one strategy to break into this arena is to start by offering Phase 4 pharmaceutical-sponsored trials. Pharmaceutical companies are usually less selective about the sites they partner with to conduct these trials so it’s a great way to establish relationships with new sponsors and prove the competence of your site.
Did you have to overcome any obstacles to get where you are today?
Clinical trials won’t make you rich but the benefits are great. Early in your career you may spend a lot of volunteer time establishing yourself with organizations you are affiliated with. I dedicated a lot of time establishing myself with ECOG, ASCO, and a local partnership with Johns Hopkins University. I was not reimbursed for my time but it was worth every minute. The work was satisfying and I was able to increasingly assume leadership positions. The expertise and professional rapport I developed enabled me to pursue additional opportunities such as giving lectures at venues such as the ASCO Annual Meeting, which is something I really enjoy doing.
What advice would you give early-career investigators?
The field is constantly changing. How do you keep up?
- Community-based research is doable and worthwhile- don’t be discouraged by people who think you need to be in academia to conduct research.
- Embrace the concept that being involved in research helps you become a better physician, and a better person.
- Appreciate that you will gain the respect of colleagues more quickly if you participate in clinical trials.
There are many journals that both report on clinical trial outcomes and review articles about conducting clinical trials. The Journal of Oncology Practice (JOP)
is a very useful resource regarding practice-related issues and conducting research.
Do you have any concluding advice?
Conducting clinical research will make you a better physician and the opportunities to conduct research in a community setting are active, rewarding, and plentiful. I’ve found that community-based research is a perfect mix of the benefits from academia and private practice settings.
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