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Ansari reflects on success and change in community oncology

In 1984, a small group of community-based oncologists and faculty members at the Indiana University Cancer Center came together with a shared mission: bring academic and community physicians together to develop cancer trials tailored to community needs. Thus, the Hoosier Cancer Research Network (formerly Hoosier Oncology Group) was founded.

Meet Rafat H. Ansari, M.D., F.A.C.P., a medical oncologist/hematologist at Michiana Hematology Oncology and one of the six founding members of Hoosier Cancer Research Network (HCRN). Before HCRN had ever set out into “infinite possibilities,” Ansari was there, laying the foundations of the future through the insight and resolve that are characteristic of the group.

Before Dr. Ansari was a Hoosier, he lived in Pakistan. He earned his medical degree from Liaquat Medical College and the University of Sind in Pakistan, where he was named Best Graduate and earned Gold Medalist in Medicine. After serving residencies at Jinnah Postgraduate Institution in Karachi, and Louis Weiss Memorial Hospital in Chicago, Dr. Ansari completed a fellowship in medical oncology and hematology at Indiana University Medical Center in Indianapolis.

“I did my fellowship in hematology/oncology with Dr. Larry Einhorn at Indiana University,” Dr. Ansari said. “I spent a lot of time with Dr. Einhorn since there were only two fellows at that time.”

After completing his fellowship, Dr. Ansari settled in South Bend, Ind., joining an existing practice of two medical oncologists at Michiana Hematology Oncology. “There was not much research at the community level at that time,” he said. Yet, Dr. Ansari did not accept the status quo.

“I had a great relationship with many of the researchers at Indiana University, like Dr. Einhorn and Dr. Pat Loehrer. We felt that to have great networking within the state of Indiana amongst these medical oncology practices, we could create a group where we do simple research trials, but these trials would be geared towards answering some very important questions,” Dr. Ansari recalled. “At our first meeting, we felt there was interest, and the Hoosier Oncology Group came into existence.”

Joining Drs. Ansari, Loehrer, and Einhorn as HOG founders were Kenneth L. Pennington, MD; R. Prasad Mantravadi, MD, FACR, FACRO, of Radiation Oncology Associates, PC, in Fort Wayne, Ind.; and William B. Fisher, MD, of IU Health Ball Memorial Cancer Center.

The collegial nature of the HOG founders’ personal relationships fostered an environment that was scientifically rigorous and enjoyable. “Not only did we do great research protocols but we had fun doing this,” Dr. Ansari said. “We would have meetings on a monthly basis and there was a lot of exchange of ideas, which for someone like me who was in a community oncology setting, was very educational. I applied those educational benefits to treating my patients.”

The group was small but productive, with HOG research protocols resulting in presentations at national meetings and publication in peer-reviewed journals.

“It was to the point that it was a model group around the country,” Dr. Ansari recalled. “Many people from different parts of the country came to visit Hoosier Oncology Group and see its functions, to see how they could go and create something like this in their state.”

Just as the group set out to do, it began answering important questions. “Hoosier Oncology Group in its initial days, presented and published some very pivotal trials,” Dr. Ansari said. “We proved that certain treatments were not effective, and we saved patients from extra expense and extra side-effects of the treatment. So, Hoosier Oncology Group’s impact was seen all over the country.”

Through membership in the HOG network, Dr. Ansari’s practice at Michiana Hematology Oncology became a gateway to the latest treatments. “It was to the point that one out of every eight or nine patients that we saw went on a research trial,” Dr. Ansari said. “Patients realized that they did not have to travel to partake in cutting-edge technology in cancer, because all of those protocols were available locally. At one time, we were doing close to 150 different protocols in different cancers locally.”

In the decades since the HOG’s founding, clinical trials have become increasingly complex and challenging, leading many community oncology practices to stop offering clinical trials to their patients. Yet, Michiana Hematology Oncology continues to provide cutting-edge research, and has successfully navigated the changing landscape of clinical research, thanks to Dr. Ansari and his colleagues.

Dr. Ansari sees a future for community-based oncology research and for community partnerships with Hoosier Cancer Research Network. “The eagerness on the part of community oncology to participate in clinical trials has not faded away,” he said. “That exists, but they want to find how practical it is to be a participant. A group like Hoosier Cancer Research Network is a perfect group for them. I do think these smaller community-based, university-based groups are the best groups, which will succeed in answering some of the important questions in oncology.”

As a veteran in oncology, having practiced for roughly four decades, Dr. Ansari has a valuable perspective on the current state of the war on cancer and an appreciation for crucial achievements.

“I have been in practice for a long time and I have seen changes from our having very few weapons against cancer to now, with lots of options available in treatment of cancers. We have also become very sophisticated in the diagnosis of cancers” he said. “The discrimination against cancer diagnosis from payers and employers is also fading away. There is a very large number of people who are cancer survivors, and these cancer survivors are viably employed. They are a source of encouragement for patients who are recently diagnosed. They see these people who have gone through cancer treatments and how functional they are.”

About Hoosier Cancer Research Network:

Hoosier Cancer Research Network (formerly known as Hoosier Oncology Group) conducts innovative cancer research in partnership with academic and community physicians and scientists across the United States and internationally. The organization provides comprehensive clinical trial management and support, from conception through publication. Created in 1984 as a program of the Walther Cancer Institute, Hoosier Cancer Research Network became an independent nonprofit clinical research organization in 2007. Since its founding, Hoosier Cancer Research Network has initiated more than 160 trials in a variety of cancer types and supportive care, resulting in more than 300 publications. More than 5,000 subjects have participated in Hoosier Cancer Research Network clinical trials.