An Interview with Robert McMaster

Dr. Robert McMaster’s term as inaugural chair of Clinical Trials BC’s Advisory Council concluded on October 27, 2020.

We interviewed Dr. McMaster virtually to chat about his role in creating Clinical Trials BC and its predecessor, and the vital role that he played in leading the operational unit’s advisory council.

Dr. McMaster is, by training, a researcher, with a doctorate in biochemistry. His areas of research are molecular immunology, parasitology, transplant immunology, and transplant biomarker research.

Currently, he’s on a research team that is studying whether renal transplant donors and recipients can be better matched by genomics, instead of looking for a tissue match (the latter is now standard in health care).

As well, he is the Vice Dean, Research at the Faculty of Medicine at UBC, and served as the Executive Director of the Vancouver Coastal Health Research Institute. The latter organization holds a large number of clinical trials, including for the treatment of COVID-19. In recognition of Dr. McMaster’s tenure as founder and inaugural advisory council chair, we asked him to explain the formation of Clinical Trials BC, impacts the team has made, and the integral role of Clinical Trials BC in the ongoing COVID-19 pandemic.

 

Forming Clinical Trials BC

Approximately ten years ago, in response to a desire to have better coordination of clinical trials across British Columbia, in collaboration with Dr Pierre Meulien, who was then Chief Scientific Officer at Genome BC, helped establish the predecessor of Clinical Trials BC, called the BC Clinical Research Infrastructure Network (BCCRIN – modelled after the Irish Clinical Research Infrastructure Network, ICRIN, that Pierre established, and the European Clinical Research Infrastructure Network.

BCCRIN was the first network of its kind in BC.

“That was the start of what was really a network across BC, of having the appropriate individuals involved in really stimulating support for clinical trials,” Dr. McMaster said. “A lot of it consisted of training for clinical trial coordinators and many aspects of what you see now in Clinical Trials BC.” Much of BCCRIN activities were led by Heather Harris as Director of Operations  and initiatives  started in BCRIN are now being implemented by Clinical Trials BC including educational programs and the Provincial CTMS. Heather is now Executive Director of the CIHR SPOR Can-SOLVE Chronic Kidney Disease Network, and Pierre is the Executive Director of the Innovative Medicines Initiative (IMI) in Europe.

Dr. McMaster served as the chair of the board of this organization (beginning in 2016), and two years later, this foundational structure was used to form the administrative basis of the BC Academic Health Science Network – of which Clinical Trials BC is now a unit.

“Clinical Trials BC is really a continuation of about 10 years of work across the province of having a real involvement of those involved in clinical trials and health authorities across BC,” he noted.

Clinical Trials BC and its predecessor were never intended to actually conduct clinical trials – they were formed to support them.

“Actually, [the entities were] formed to support those doing trials whether it’s in your community or through health authorities, hospitals or universities,” Dr. McMaster said.

 

CTBC’s Impact

Continuing on the work of BCCRIN, Clinical Trials BC has further developed the initial efforts in training and assistance made to support the clinical research community in BC.

“I think [Clinical Trials BC] certainly allows much better coordination across sites for more multisite trials,” Dr. Master said. “[Clinical Trials BC puts] a lot into quality and regulation for clinical trials. We have provided many educational programs for those that are conducting clinical trials to enable their certification in many different steps of the process.”

He noted that a core value of Clinical Trials BC is the coordination of the clinical research community across the province, and its role in enabling a higher level of professional development for individuals.

“It’s not that [clinical researchers and trialists] weren’t trained,” he noted, “but Clinical Trials BC enables that training to continue, or for new people coming in, to give them a training platform.”

Another aspect where Clinical Trials BC has changed the research landscape in the province is through awareness. Dr. McMaster recognized that the team is creating awareness of what clinical trials are like in other regions of BC, and this information is enhancing multisite clinical trials across BC.

Ultimately, Clinical Trials BC’s coordination of the clinical researchers is creating opportunities for patients in British Columbia to make a lasting impact in the health system.

“What we’re really doing is giving the patient an opportunity to be participate in clinical trials,” Dr. McMaster said. “I think it’s important to look at it from the patient point of view – that they have an equal opportunity to participate in clinical trials, no matter where they live geographically. From a patient point of view, it has had a huge impact.”

Dr. McMaster is also wholly committed to a high-quality patient experience, acting as principal investigator in a now-concluded study that utilized a survey of patients in an effort to improve their experience in clinical trials. The results of the survey led to a provincial working group that included three patient and public members who developed and released the Best Practices for Communications Study Results to Clinical Trial Participants in March 2020.

 

COVID-19 Impacts and Response

Early in the global COVID-19 pandemic (March to June 2020), Dr. McMaster described a large-scale curtailment in the volume of clinical trials held in BC due to the altered focus in hospitals and in clinics.

“Clinical research parallels the clinic because many of the sites for clinical trials are concurrent with treatment,” noted Dr. McMaster.

The impact of COVID-19 on the trials was unmistakeable, and while contracts to hold them still existed, most BC existing trials ground to a halt.

Immediately responding to this change in March, Dr. McMaster helped to create the COVID-19 Clinical Research Coordination Initiative (CRCI) to coordinate and begin COVID-19-related clinical trials in BC (CTBC is a member of its Clinical Research Committee). The goal was to have these trials begin at as many health sites as possible across BC – some of which had never hosted a trial before. The CRCI team found that when mobilizing sites for these trials, there was a need for more capacity building for clinical trials, even where substantial patients existed.

“I think COVID-19 really highlighted that [the sites] didn’t have any lack of expertise,” he said. “It was just a lack of a number of coordinated sites that could transition over to clinical trials, whereas other sites in more urban centres could implement the trials quite quickly.”

Nearly eight months into the pandemic, non-COVID-related trials are “slowly picking back up again and actually ramping up quite quickly as the clinics reopen” – though not to the full extent that they existed one year ago. While the number of trials recovers, the need for capacity development for clinical researchers in the new research environment has correspondingly increased.

 

Clinical Trials BC’s Role in the Pandemic

Clinical Trials BC has been meeting this need. To complement CRCI’s efforts to build capacity, Clinical Trials BC has been updating provincial stakeholders on what clinical trials are available across the world and where BC fits in, in addition to providing rapid training and regulatory consultations.

“Alison Orth’s work with Clinical Trials BC’s COVID response has been hugely successful,” Dr. McMaster noted. “They’re keeping people up to date on those actually conducting the trials, what trials are in operation, what is available, what could be implemented at different locations and best practices for those going forward. So I think it’s been hugely beneficial for the BC community.”

 

Chairing the Advisory Council

The CTBC Advisory Council’s work has been greatly augmented during the pandemic. Upon recommendation from Dr. McMaster and the advisory committee in March 2020, Clinical Trials BC organized a COVID-19 network focusing on keeping stakeholders up to date on provincially-based trials. This network meets monthly.

Another major accomplishment in 2020 is the launch of the provincial Clinical Trials Management System, which has been the project of a working group formed five years ago, stemming from a Council-approved unit workplan.

The upcoming Clinical Trials Conference (which was postponed from its original date in May 2020) had much input from the Advisory Council for content and guest speakers, and the expertise brought by members (and their respective networks) will inform the event when it’s held on a new date in January 2021.

Other areas of advisement Dr. McMaster noted, include the continuation and increase in the quality systems and the training for quality and regulations across BC, “because you need that [support] in order to have the updated expertise to be able to conduct clinical trials, and that area is continually changing.” This active engagement ensures that BC trials and personnel are always up-to-date globally, so more clinical trials can be hosted in BC.

“It’s a very valuable and a very thoughtful Advisory Committee, and we’re providing opportunities for patients across BC for clinical trials,” Dr. McMaster said.

 

Closing Thoughts

What kind of lasting legacy does Dr. McMaster think he’ll leave to the BC clinical research community, as founder and outgoing Advisory Council Chair at Clinical Trials BC?

“It’s the establishment of Clinical Trials BC and how it’s an important activity of the BC Academic Science Network –  I think that’s huge,” he answered immediately. The ‘N’ in BCCRIN was for ‘network,’ but it was a volunteer network. Now it’s established as a network across BC which then interacts both across Canada, and globally.”

“This is a huge success for British Columbia,” he continued. “[Clinical Trials BC] is now embedded into the network, embedded into the health authorities and embedded in the universities and colleges across BC.”

Clinical Trials BC  would like to sincerely thank Dr. McMaster for his ongoing service in multiple roles across the organization. He will continue to be involved in the organization in other capacities in the future.