Advancement of clinical knowledge requires a self-perpetuating loop that consists of clinical trials, evaluation of the adoption of the results of the studies by medical providers, determination of knowledge gaps and barriers to implementation of new evidence, and generation of a new set of clinical trials. We are involved in all phases of the Clinical Research Loop.

1. Clinical Trials: The major leaps in clinical care are achieved through meticulously designed and executed clinical trials that either prove and disprove a benefit to a new intervention. As a laboratory of Clinical Research in the Department of Radiation Medicine, we study ways to improve the efficacy of radiation therapy –by investigating the role of RT in new areas, questioning the role of RT in other areas, learning to target RT more precisely with novel imaging modalities, determining how RT can be combined with novel systemic agents. Most of our prospective studies are done in collaboration with other departments. Below is the list of some of our studies in various phases of design, preparation, patient accrual and analysis:

• Adjuvant radiation therapy for patients with Dupuytren's Contractures after surgical or enzymatic release of advanced contractures
• Localization of involved regional lymph nodes with USPIO-MRI in Esophageal Cancer
• Localization of involved regional lymph nodes with USPIO-MRI in Rectal Cancer
• Addition of Bladder-directed radiation therapy to Immunotherapy in metastatic bladder cancer
• Combination of Conventionally and Hypofractionated Radiation Therapy with Immunotherapy in Stage II/III non-operable NSCLC
• Alternating Electric Fields as an Alternative to Prophylactic Cranial Irradiation in patients with Small Cell Lung Cancer
• Assessment of effect of Palliative Radiation Oncology (PRADO) clinic model on outcomes of patients with incurable malignancies.

1. The adoption of results of clinical trials in the real world is not immediate and may be hindered by lack of knowledge, financial and other barriers. We conduct National Cancer Data Base analyses to determine the patterns of treatments and outcomes for common malignancies where standard of care has been established through rigorous clinical trials, as well as rare conditions, in which clinical trials are not possible. Below is the list of NCDB projects we have conducted with our colleagues:

• Rectal Cancer (Cancer Journal)
• Gallbladder Cancer (Lancet)
• Breast Angiosarcoma

1. Despite clinical evidence from published clinical trials, the daily practice of medicine by providers may be in a stark contrast to established guidelines. Large retrospective population-based analysis cannot capture the most current views and practices of treating physicians. Survey-based analysis of current patterns of treatment, with evaluation of association of respondents' characteristics, knowledge base, allows us to determine the future direction for clinical trials. Some of our survey-based analysis work is presented below:  
   

• Seminoma   
• ES-SCLC   
• LS-SCLC   
• Prostate   
• Breast Angiosarcoma   
• Esophagus   
• Bladder   
• Rectal cancer

Publications:

• NCBI List
  

Additional Links :

• The role of biomarkers in bladder preservation management of muscleinvasive bladder cancer
  

• Dr. Mitin is co-PI of CRUK CEDAR Spark Award for his proposal
  
• Bridging the Gap in Global Advanced Radiation Oncology Training: Impact of a Web-Based Open-Access Interactive Three-Dimensional Contouring Atlas on Radiation Oncologist Practice in Russia
  
• Dramatically Polarized Opinion on the Role of Brachytherapy Boost in Management of High-risk Prostate Cancer: A Survey of North American Genitourinary Expert Radiation Oncologists
  
• On thin ice: barriers to adoption of surveillance for patients with stage I testicular seminoma. Survey of US radiation oncologists[intbrazjurol]
  
• Dr. Mitin was faculty member at Spring 2018 Russian Cancer Congress, Moscow