{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T10:22:32Z","timestamp":1696069352777},"reference-count":68,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Bulletin of Medical History"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>Clinical cancer research in Canada entered a new phase in 1971. In that year, the National Cancer Institute of Canada agreed to initiate and support a multidisciplinary cooperative clinical trials program. The first collaborative randomized controlled trial (RCT) for the treatment of advanced Hodgkin\u2019s disease was launched in medical centres across the country in December 1971. Simultaneously, in the United States, the National Cancer Act came into effect. To what extent were these Canadian and American developments coincidental? I argue that the cooperative clinical trials program in Canada was timed to coincide with the US declaration of war on cancer, but it was not its corollary. Against the background of this American anti-cancer campaign, the cooperative clinical trials program emerged as a link between the strong radiotherapy tradition in Canada and the new trial infrastructure of chemotherapeutic regimes in the United States. The evolution of the Hodgkin\u2019s disease trial serves as a good example to demonstrate how growing collaboration among Canadian and American physician\u2013investigators brought about a large-scale national study. The latter became a prototype of further cooperative oncological RCTs in Canada during the 1970s.<\/jats:p>","DOI":"10.3138\/cbmh.361-052019","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T23:28:16Z","timestamp":1585092496000},"page":"23-49","source":"Crossref","is-referenced-by-count":0,"title":["The Beginnings of the Canadian Cooperative Clinical Cancer Trials Program and the American\u00a0Influences, 1962\u201376"],"prefix":"10.3138","volume":"37","author":[{"given":"Fedir","family":"Razumenko","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1696","reference":[{"key":"fn1","unstructured":"David Cantor, ed.Cancer in the Twentieth Century(Baltimore, MD: Johns Hopkins University Press, 2008), 24\u201330."},{"key":"fn2","doi-asserted-by":"crossref","unstructured":"Ernest A. McCulloch,The Ontario Cancer Institute: Successes and Reverses at Sherbourne Street(Montreal: McGill-Queen\u2019s University Press, 2003), 34\u201335.","DOI":"10.1515\/9780773570948"},{"key":"fn3","unstructured":"Leslie A. Gaudette and Judy Lee,Cancer Incidence in Canada: 1969\u20131993(Ottawa: Statistics Canada, 1997),x\u2013xii. For a discussion of intractability and failure in the history of cancer research and treatment, see Carsten Timmermann,A History of Lung Cancer: The Recalcitrant Disease(Houndsmills\/Basingstoke, UK: Palgrave Macmillan, 2014)."},{"key":"#cr-split#-fn4.1","unstructured":"For American and European developments in these domains, see Peter Keating and Alberto Cambrosio, Cancer on Trial: Oncology as a New Style of Practice (Chicago\/London: University of Chicago Press, 2012), 34-35. In a Canadian context, consult Charles Hayter, An Element of Hope: Radium and the Response to Cancer in Canada, 1900-1940 (Montreal\/Kingston: McGill-Queen's University Press, 2005)"},{"key":"#cr-split#-fn4.2","doi-asserted-by":"crossref","unstructured":"Robert A. Macbeth, \"The Origin of the Canadian Cancer Society,\" CMBH\/BCHM 22 (2005): 155-73","DOI":"10.3138\/cbmh.22.1.155"},{"key":"#cr-split#-fn4.3","doi-asserted-by":"crossref","unstructured":"and David A.E. Shephard, \"First in Fear and Dread: Cancer Control in Saskatchewan, the First Decade - 1929-1939,\" CMBH\/BCHM 20 (2003): 323-42.","DOI":"10.3138\/cbmh.20.2.323"},{"key":"fn5","doi-asserted-by":"crossref","unstructured":"See Charles Hayter, \u201cCancer: \u2018The Worst Scourge of Civilized Mankind,\u2019\u201dCMBH\/BCHM20 (2003): 251\u201364 and other articles inCMBH\/BCHM20.","DOI":"10.3138\/cbmh.20.2.251"},{"key":"fn6","doi-asserted-by":"crossref","unstructured":"Peter Keating and Alberto Cambrosio, \u201cCancer Clinical Trials: The Emergence and Development of a New Style of Practice,\u201dBulletin of the History of Medicine81 (2007): 197\u2013223.","DOI":"10.1353\/bhm.2007.0003"},{"key":"fn7","doi-asserted-by":"crossref","unstructured":"For a discussion on this methodological approach, see Gil Eyal, \u201cFor a Sociology of Expertise: The Social Origins of the Autism Epidemic,\u201dAmerican Journal of Sociology118 (January 2013): 869\u201378.","DOI":"10.1086\/668448"},{"key":"fn8","unstructured":"S.J. Pocock, P. Armitage, and D.A.G. Gallon, \u201cThe Size of Cancer Clinical Trials: An International Survey,\u201d in Peter Armitage, D.\u00a0Bardelli, D.A.G. Gallon, E.A. Gehan, G.A. Higgins, K. Magnus, A.B. Miller, S.J. Pocock, and R. Saracci, eds.Methods and Impact of Controlled Therapeutic Trials in Cancer: Part I, UICC Technical Report Series \u2013 Vol. 36 (Geneva: IUAC\/UICC, 1978), 5\u201325."},{"key":"fn9","doi-asserted-by":"crossref","unstructured":"Thomas C. Chalmers, Jerome B. Block, and Stephanie Lee, \u201cControlled Studies in Clinical Cancer Research,\u201dNew England Journal of Medicine287 (1972): 75\u201378.","DOI":"10.1056\/NEJM197207132870205"},{"key":"fn10","doi-asserted-by":"crossref","unstructured":"M.J.R. Healy and R. Saracci, \u201cReport of a Symposium Sponsored by the UICC on Principles and Practice in Clinical Trials,\u201dInternational Journal of Cancer8 (1971): 541\u201345.","DOI":"10.1002\/ijc.2910080323"},{"key":"fn11","unstructured":"National Cancer Institute of Canada, \u201cMinutes of the Second Meeting of the Clinical Advisory Committee, Toronto, 15 February 1962,\u201d p. 4, in the University of Toronto Archives (hereafter UTA), University of Toronto. Faculty of Medicine, A86-0035\/003(01)."},{"key":"fn12","unstructured":"Gordon E. Richards, \u201cReport of Board of Directors of the First Year\u2019s Activities of National Cancer Institute of Canada, 7\u20138 May 1948, 3, in the Western Archives, Western University (hereafter WUA), the University of Western Ontario, Office of the President Fonds, Series 6: George Edward Hall, AFC 40 - 19\/20, NCIC, 1947\u201348."},{"key":"fn13","unstructured":"Richards, \u201cReport,\u201d 3\u20134."},{"key":"fn14","unstructured":"Richards, 4."},{"key":"fn15","doi-asserted-by":"crossref","unstructured":"For more details on Harold Warwick, see Don Cowan, \u201cOrlando Harold Warwick,\u201dThe Globe and Mail, Toronto, 21 May 2010: L.6 and D.H. Cowan, \u201cO. Harold Warwick: Canada\u2019s First Medical Oncologist,\u201dCurrent Oncology18 (2011): 117\u201320.","DOI":"10.3747\/co.v18i3.425"},{"key":"fn16","unstructured":"O.H. Warwick, \u201cSelachyl Alcohol as an Adjunct to Radiation Treatment of Cancer of the Cervix (A Preliminary Report),\u201d London, ON, 1967; in the WUA, AFC 328.1.1243, Alkoxyglycerols, 1964\u201367."},{"key":"fn17","unstructured":"McCulloch,The Ontario Cancer Institute, 7\u20138."},{"key":"fn18","unstructured":"See \u201cReport of the Director, Clifford L. Ash, M.D., 7 May 1959,\u201d in the University Health Network Archives, OCI SF1: 1.32."},{"key":"fn19","unstructured":"Edward L. Shorter,A Century of Radiology in Toronto(Toronto: Wall and Emerson, 1995), 46\u201349."},{"key":"fn20","unstructured":"See \u201cSymposium on Hodgkin\u2019s Disease,\u201dCancer Research26 (1966): 1045\u201346 and 1232. Also Ruth E. Alison and D.M. Whitelaw, \u201cA Comparison of Nitrogen Mustard and Vinblastine Sulfate in the Treatment of Patients with Hodgkin\u2019s Disease,\u201dCanadian Medical Association Journal102 (14 February 1970): 278\u201380."},{"key":"fn21","doi-asserted-by":"crossref","unstructured":"For an overview of the organization of cooperative clinical trials in the United States, see John V. Pickstone, \u201cContested Cumulations: Configurations of Cancer Treatments through the Twentieth Century,\u201dBulletin of the History of Medicine81 (2007): 182\u201384.","DOI":"10.1353\/bhm.2007.0011"},{"key":"fn22","doi-asserted-by":"crossref","unstructured":"Peter Keating and Alberto Cambrosio, \u201cBeyond \u2018Bad News\u2019: The Diagnosis, Prognosis and Classification of Lymphomas and Lymphoma Patients in the Age of Biomedicine (1945\u20131995),\u201dMedical History47 (2003): 296\u201399.","DOI":"10.1017\/S0025727300057021"},{"key":"fn23","unstructured":"This number included clinical studies of the whole spectrum: Phases I, II, and III. See \u201cCare and Training Tabulation for Cooperative Groups,\u201d stamped by the University of Alberta Dean of Medicine\u2019s Office, Edmonton, 2 October 1969; in the University of Alberta Archives (hereafter, UAA), Acc. No. 81-70-358, 13-A-10."},{"key":"fn24","unstructured":"For an overview of the US cancer research framework, see Keating and Cambrosio,Cancer on Trial, 87\u2013108."},{"key":"fn25","unstructured":"Alan R.P. Paterson to Walter H. Johns, Edmonton, 4 October 1966, and Walter C. MacKenzie, \u201cNotes for the Opening of the New McEachern Cancer Research Laboratory,\u201d Edmonton, 28 September 1972. Both files in the UAA, Acc. No. 80-162-199, 6-A-107."},{"key":"fn26","unstructured":"M. Vera Peters, \u201cThe Value of Local or Regional Radiation in Early Hodgkin\u2019s Disease,\u201d OCTRF Project No. 181 (Grant 41-13), 1967; in the OCTRF,Annual Report 1968, 178\u201379; in the University of Saskatchewan Libraries, Archives and Special Collections (thereafter, USL), MG 404, box 11."},{"key":"fn27","unstructured":"This combination chemotherapy consisted of methylhydrazine, cyclophosphamide, vinblastine, and prednisone. See the OCTRF,Annual Report 1968, 149."},{"key":"fn28","unstructured":"See Provincial Cancer Hospitals Board, Meeting No. 6, item C-5, 16 October 1969; in the UAA, Acc. No. 81-70-358, 13-A-10. For a personal account on these developments, consult Pierre R. Band,Therapeutic Revolution: The History of Medical Oncology from Early Days to the Creation of the Subspecialty(Sh\u0101riqah, United Arab Emirates: Bentham Science Publishers, 2014)."},{"key":"fn29","unstructured":"Lyonel G. Israels and Daniel E. Bergsagel, \u201cA Report to the Clinical Advisory Committee, NCIC,\u201d 18 September 1968; in the WUA, AFC 328.1.2176."},{"key":"fn30","unstructured":"Gregory P. Marchildon,Health Systems in Transition: Canada(Toronto: University of Toronto Press, 2005), 20\u201323 and 26\u201327."},{"key":"fn31","doi-asserted-by":"crossref","unstructured":"Jacalyn Duffin, \u201cPoisoning the Spindle: Serendipity and Discovery of the Anti-Tumor Properties of the Vinca Alkaloids,\u201dCMBH\/BCHM17 (Spring 2000): 168\u201369.","DOI":"10.3138\/cbmh.17.1.155"},{"key":"fn32","unstructured":"Harold Warwick, \u201cThe Beginnings of Vinca Alkaloids,\u201d inCancer in Ontario 1982(Toronto: OCTRF, 1983), 25\u201326."},{"key":"fn33","unstructured":"O.H. Warwick, J.M.M. Darte, and T.C. Brown, \u201cSome Biological Effects of Vincaleukoblastine, an Alkaloid inVinca roseaLinn in Patients with Malignant Disease,\u201dCancer Research20 (1960): 1032\u201340."},{"key":"fn34","unstructured":"A.J. Phillips to Dr. Stella Booth, Toronto, 11 July 1968; in the UTA, A86-0035\/03(07)."},{"key":"fn35","unstructured":"Application form for a fellowship in the American College of Epidemiology, enclosed with correspondence from A.B. Miller to Curtis Mettlin, Toronto, 28 November 1984; in the UTA, A86-0035\/034(08)."},{"key":"fn36","unstructured":"Canadian Who\u2019s Who Biographical Data Form, A.B. Miller, 29 March 1985; in the UTA, A86-0035\/034(08)."},{"key":"fn37","doi-asserted-by":"crossref","unstructured":"For background information on A.B. Miller, see Carsten Timmermann, \u201cAs Depressing as It Was Predictable? Lung Cancer, Clinical Trials, and the Medical Research Council in Postwar Britain,\u201dBulletin of the History of Medicine81 (2007): 328\u201331.","DOI":"10.1353\/bhm.2007.0012"},{"key":"fn38","unstructured":"Richard A. Rettig,Cancer Crusade: The Story of the National Cancer Act of 1971(Princeton, NJ: Princeton University Press, 1977), 17 and 296\u2013301."},{"key":"fn39","unstructured":"National Panel of Consultants on the Conquest of Cancer, Report 91-1402, 91st Congress, 2nd Session (Washington, DC: Government Printing Office, 1970): 59\u201362."},{"key":"fn40","doi-asserted-by":"crossref","unstructured":"Frank J. Rauscher, \u201cThe National Cancer Program Plan,\u201dCA: A Cancer Journal for Clinicians23 (1973): 47. Rauscher was Director of the National Cancer Institute in Bethesda, Maryland.","DOI":"10.3322\/canjclin.23.1.47"},{"key":"fn41","unstructured":"Ilana L\u00f6wy,Between Bench and Bedside: Science, Healing, and Interleukin-2 in a Cancer Ward(Cambridge, MA: Harvard University Press, 1996), 37."},{"key":"fn42","unstructured":"R.M. Taylor to L.G. Israels, Toronto, 2 December 1970; in the UTA, A86-0035\/03(01)."},{"key":"fn43","unstructured":"The Clinical Advisory Committee consisted of Daniel E. Bergsagel (chemotherapy; Chief Physician, the OCI\/PMH), Thomas C. Brown (Pathologist-in-Chief, the OCI\/PMH), L.G. Israels (hematology\u2013chemotherapy; Director of Research, Manitoba Cancer Treatment and Research Foundation), Robert A. Macbeth (Professor and Chairman, Department of Surgery, University of Alberta), Thomas A. Watson (therapeutic radiology; Director, London Cancer Clinic, Ontario), and Donald M. Whitelaw (chemotherapy; Senior Research Physician, British Columbia Cancer Institute). See R.M. Taylor to D.E. Bergsagel, Toronto, 30 December 1970; and R.M. Taylor to members of the Clinical Advisory Committee, 30 March 1971; both in the UTA, A86-0035\/03(01)."},{"key":"fn44","unstructured":"For a discussion on the decision-making process behind this trial, see Fedir Razumenko, \u201cA Versatile Medical Substance, DMPA, and Its Transition from Hospitals to Cancer Clinics and Psychiatric Institutions in Canada, 1950\u20131982,\u201dJournal of the History of Medicine and Allied Sciences(forthcoming)."},{"key":"fn45","unstructured":"Agenda for a meeting of the NCIC Clinical Advisory Committee, Toronto, 26 February 1971; in the UTA, A86-0035\/03(01)."},{"key":"fn46","doi-asserted-by":"crossref","unstructured":"D.E. Bergsagel, P.J. Migliore, and K.M. Griffith, \u201cMyeloma Proteins and the Clinical Response to Melphalan Therapy,\u201dScience148 (1965): 376\u201337; and McCulloch,Ontario Cancer Institute, 42\u20133.","DOI":"10.1126\/science.148.3668.376"},{"key":"fn47","unstructured":"Gaudette and Lee,Cancer Incidence,xiiandxiii."},{"key":"fn48","unstructured":"These numbers corresponded to 3.5 male and 2.4 female new cases of Hodgkin\u2019s disease per 100,000 Canadians in 1970. Gaudette and Lee, 13, 16, 32, and 35."},{"key":"fn49","unstructured":"Gaudette and Lee, x."},{"key":"fn50","unstructured":"Gaudette and Lee, 9 and 52."},{"key":"fn51","unstructured":"Italics in the original. J.M.W. Gibson, \u201cThe Radiotherapist\u2019s Hopes for Radiobiology,\u201d in P.G. Scholefield, ed.Proceedings of the Ninth Canadian Cancer Research Conference(Toronto: University of Toronto Press, 1971), 219."},{"key":"fn52","unstructured":"R.M. Taylor to G.J. Goldenberg, Toronto, 23 March 1971; in the UTA, A86-0035\/03(01)."},{"key":"fn53","unstructured":"See \u201cSymposium on Hodgkin\u2019s Disease,\u201d 1045\u20136 and 1232. Also Alison and Whitelaw, \u201cA Comparison,\u201d 278\u201380."},{"key":"fn54","unstructured":"M. Vera Peters, \u201cThe Evolution of Concept in the Control of Hodgkin\u2019s Disease,\u201d in the UTA, Vera Peters fonds B1996-0019\/3(02)."},{"key":"fn55","unstructured":"Vincent T. DeVita, Arthur A. Serpick, and Paul P. Carbone, \u201cCombination Chemotherapy in the Treatment of Advanced Hodgkin\u2019s Disease,\u201dAnnals of Internal Medicine73 (1970): 885 and 894."},{"key":"fn56","unstructured":"D.E. Bergsagel, R.E. Alison, D.H. Cowan, R. Hasselback, and J.W. Meakin, \u201cClinical Trials of Chemotherapeutic Agents at the Ontario Cancer Institute \u2013 \u2018Hodgkin\u2019s Disease, Stages IIIB and IV,\u2019\u201d in The OCTRF,Annual Report 1969, 149\u2013150; in the USL, MG 404, box 11."},{"key":"fn57","unstructured":"Protocol,Hodgkin\u2019s Disease, Stages IIIB and IV \u2013 A Canadian Cooperative Clinical Trial, February 1971; in the UTA, A86-0035\/03(01)."},{"key":"fn58","unstructured":"Protocol,Hodgkin\u2019s Disease, 1."},{"key":"fn59","unstructured":"Protocol, 2."},{"key":"fn60","unstructured":"See D.M. Whitelaw to L.G. Israels, Vancouver, 12 March 1971; in the UTA, A86-0035\/03(01)."},{"key":"fn61","unstructured":"Whitelaw to Israels."},{"key":"fn62","unstructured":"L.G. Israels to R.M. Taylor, Winnipeg, 9 February 1971; in the UTA, A86-0035\/03(01)."},{"key":"fn63","unstructured":"NCIC Protocol,A Cooperative Clinical Trial Comparing MOPP Alone Versus MOPP Followed by Radiation in Stage IIIB and IV Hodgkin\u2019s Disease(1971), 1\u20132."},{"key":"fn64","unstructured":"\u201cCentres Participating in the Hodgkin\u2019s Disease Clinical Trial,\u201d enclosed with correspondence from A.B. Miller to Clinical Advisory Committee, 3 February 1972; in the UTA, A1986-0035\/03(02). By 1973, the number of participating institutions increased to twenty-one, including those in Nova Scotia and New Brunswick. See \u201cHodgkin\u2019s Disease Trial, Stages III and IV, patient Enrolment to Sept. 14, 1976\u00a0\u2013 Closing Date,\u201d in the WUA, AFC 328.1.2654 Trial \u2013 Hodgkin\u2019s Disease, 1969\u20131979."},{"key":"fn65","unstructured":"Hodgkin\u2019s Disease Trial: Dates of Registration for Eligible and Not Eligible Patients, 4 March 1974, enclosed with Agenda of the Third Meeting of Participants in NCIC Clinical Trials, Edmonton, March 1974; in the UTA, A1986-0035\/038(04)."},{"key":"fn66","unstructured":"L. Yelle, A. Willan, and J. Pater, \u201cTrial of Chemotherapy and Radiotherapy in Advanced Hodgkin\u2019s Disease,\u201dClinical and Investigative Medicine10 (1987): B81."}],"container-title":["Canadian Bulletin of Medical History"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/utpjournals.press\/doi\/pdf\/10.3138\/cbmh.361-052019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T02:22:54Z","timestamp":1695954174000},"score":1,"resource":{"primary":{"URL":"https:\/\/utpjournals.press\/doi\/10.3138\/cbmh.361-052019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":68,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.3138\/cbmh.361-052019"],"URL":"https:\/\/doi.org\/10.3138\/cbmh.361-052019","relation":{},"ISSN":["0823-2105","2371-0179"],"issn-type":[{"value":"0823-2105","type":"print"},{"value":"2371-0179","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4]]}}}