Evaluative Clinical Sciences

Education:

• B.Sc., 1991, physics, University of British Columbia
• MD, 1995, Queen’s University
• FRCPC, 2000, radiation oncology, University of Toronto
• M.Sc., 2002, clinical epidemiology, U of T
• FRCPC, 2002, clinician investigator program, U of T

Appointments and Affiliations:

• Scientist, Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Research Institute
• Clinician scientist, Ontario Association of Radiation Oncology
• Professor, department of radiation oncology, U of T
• Professor, Institute of Health Policy, Management and Evaluation, U of T
• Co-chair, genitourinary cancer disease site group, Cancer Care Ontario
• Co-chair, genitourinary guidelines advisory group, American Society of Clinical Oncology

Research Focus:

• Design and conduct of clinical trials to improve the health care system and outcomes for men with prostate cancer
• Development of clinical practice guidelines

Research summary:

Dr. Loblaw has formal training and expertise in clinical trial design, conduct and analysis and has been awarded grants to investigate new radiotherapy techniques and hormonal manoeuvres. The main goal of his research is to document the feasibility, tolerability and efficacy of stereotactic ablative radiotherapy (SABR) using standard linear accelerators. His group is one of a few internationally that has been recognized for this paradigm-changing work. Dr. Loblaw is the principal investigator (PI) or co-PI on eight prospective clinical trials: six are supported by peer-reviewed grants; two are randomized controlled trials and one is a multicentre study.

The foundations of evidence-based medicine are systematic reviews and the resulting clinical practice guidelines (CPG), which apply all the data on a given topic to clinical practice. As such, CPGs are widely disseminated and used in funding decisions and audits of quality of care. Dr. Loblaw is the co-chair of the program in evidence-based care genitourinary group at Cancer Care Ontario and the genitourinary guidelines advisory group at the American Society of Clinical Oncology. He continues to lead guidelines for the management of androgen-sensitive prostate cancer, castrate-resistant prostate cancer and malignant spinal cord compression, this last a complication that prostate cancer patients are at high risk of developing.

His group has shown that five treatments of SABR can be as effective and toxic as 38 treatments of external beam radiation for low-risk prostate cancer patients. With 33 fewer visits, the SABR approach is more convenient for patients, saves almost $2,000 in out-of-pocket costs, increases radiotherapy throughput seven-fold and decreases per patient departmental costs by 80%. Based on these findings, Dr. Loblaw has been awarded peer-reviewed grants to further study and refine these approaches, including one for a national, multicentre, phase 2 randomized study.

These guidelines have been published and widely cited in high-impact peer-reviewed journals, and have led to new and revised practice standards internationally. Dr. Loblaw is addressing new questions arising from his previous work with studies such as the multicentre, randomized study of early versus late androgen deprivation therapy (ELAAT). His work and the guidelines he has developed have had a significant impact on patient and health care outcomes. For example, he was the senior author on a recent Cancer Care Ontario guideline on the use of low-dose rate brachytherapy. This guideline led to a Cancer Care Ontario funding decision that will allow patients with intermediate-risk disease to have access to this highly effective therapy, which requires a single outpatient treatment.

Dr. Loblaw has authored over 190 peer-reviewed papers and received over $17 million in grant funding.

Selected publications:

See current publications list at PubMed.

1. Basch E, Loblaw DA, Oliver TK, Carducci M, Chen RC, Frame J, Garrels K, Hotte S, Kattan M, Raghavan D, Saad F, Taplin ME, Walker-Dilks C, Williams J, Winquist E, Wooten T, Virgo K. Systemic therapy in men with metastatic C-castration-resistant prostate cancer (CRPC): American Society of Clinical Oncology and Cancer Care Ontario Clinical Practice Guideline. J Clin Oncol.2014 Oct; 32(30):3436–48.
2. Loblaw DA, Cheung P, D’Alimonte L, Deabreu A, Mamedov A, Zhang L, Tang C, Quon H, Jain S, Pang G, Nam RK. Prostate stereotactic body ablative radiation using a standard linear accelerator: toxicity, biochemical, and pathological outcomes. Radiother Oncol. 2013 May;107(2):153–8.
3. Loblaw DA, Prestrud AA, Somerfield MR, Oliver TK, Brouwers MC, Nam RK, Lyman GH, Basch E. American society of clinical oncology clinical practice guidelines: formal systematic review-based consensus methodology. J Clin Oncol. 2012 Sep 1;30(25):3136–40.
4. Tang CI, Loblaw DA, Cheung P, Holden L, Morton G, Basran P, Tirona R, Cardoso M, Pang G, Gardner S. Phase II study of a five-fraction hypofractionated accelerated radiotherapy for low risk localized prostate cancer: early results of pHART3. Clin Oncol. 2008;20(10):729–37.
5. Loblaw DA, Virgo KS, Nam R, Somerfield M, Ben-Josef E, Mendelson DS, Middleton R, Porterfield H, Sharp SA, Talcott J, Taplin ME, Vogelzang NJ, Wade JL, Bennett CL, Scher HI; American Society of Clinical Oncology. Initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer: 2006 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol. 2007 Apr 20;25(12):1596–1605.

• Toronto hospital tests new, high-precision method of prostate cancer treatment, CTV News, Oct 12, 2015
• Surviving Prostate Cancer, Rogers Daytime TV, November 22, 2013
• Research and Innovation: A Prostate Cancer Knockout, The Globe and Mail, October 24, 2013
• Treatment options let patients get back to life, Toronto Star, June 5, 2008

Related Links:

• U of T profile, department of radiation oncology