Tuesday , 2 September 2014

Clinical trials key to curing all cancers

Also published as a special contribution to the The Telegraph (Macon, GA), as an editorial in The Augusta Chronicle, in the Atlanta Business Chronicle, and in The Albany Journal.

Overall cancer death rates have steadily declined over the past 20 years, according to the National Cancer Institute’s March 2012 Annual Report to the Nation on the Status of Cancer, 1975-2008.

NCI Director Harold E. Varmus, M.D., confirmed, “The continued declines in death rates for all cancers, as well as the overall drop in incidence, is powerful evidence that the nation’s investment in cancer research produces life-saving approaches to cancer prevention, screening, diagnosis and treatment.”

About 30 percent of that investment involves treatment research, including clinical trials, says an Institute of Medicine report.

Cancer clinical trials take new therapies from the lab — where they have already been extensively researched in both bench and animal studies — to the clinic, where patients with cancer can participate, if they qualify. According to the NCI, more than 2,000 clinical trials are in progress today accepting both children and adults with cancer — and because of clinical trials, 12 new drugs or drug uses were FDA-approved in 2010.

Yet, it’s worthwhile to note that in Georgia, cancer deaths in certain areas — such as breast cancer and lung cancer in women — have actually been increasing, according to the latest edition of the Georgia Cancer Data Report (2005). This is why centers in Georgia such as the GRU Cancer Center are revving up our work in clinical trials.

The GRU Cancer Center alone has 90 phase I, II or III clinical trials open, with 12 new trials set to launch soon. Those with cancer participating in clinical trials can benefit in two ways. First, they can receive promising and innovative cancer treatments not available to the general public.

While not all clinical trials focus on advanced cancers, a number of our patients have tried all other possible options, and they’re not ready to stop trying.

Second, these patients have a unique opportunity to help other patients with cancer. And based on conversations with our patients, that is by far the most important reason most of them participate in clinical trials. They tell us, “I want to do this so my grandchildren have a treatment option.”

Over the past several decades, we’ve seen this hope come to fruition. For example, because of clinical trials, a type of immunotherapy called Herceptin has increased the life expectancy of patients with HER2+, an aggressive type of breast cancer.

Our researchers are also combining immunotherapy agents with other cancer-fighting drugs to boost their effectiveness. And I have opened two new trials — both the first of their kind — investigating immunotherapy-based treatments to improve survival rates for advanced prostate cancer and pancreatic cancer.

Another rapidly growing area is molecular targeted agents, or MTAs — drug therapies that target the molecules involved in cancer growth. We’re using MTAs in clinical trials here for cancers such as leukemia and lymphoma.

But for clinical trials to happen — and for new drugs to be developed — we need two things. Dr. Varmus mentions the first in a follow-up to his earlier statement: “It is also important to note that investments we make today are critical if we hope to see these declines in incidence and death from cancer reflected in future Reports to the Nation.”

Along with increased funding — particularly for historically lower-funded diseases such as lung and pancreatic cancer — we also need to increase awareness among both patients and physicians about clinical trials. As an example, our cancer center never fails to consider whether a patient might be a candidate for a trial.

Because of clinical trials, we can proudly say that 50 percent of cancers can be cured today. But 50 percent is not all cancers. We hope to reach that goal one day — especially with advanced cancers. Are we there yet? Not yet, but hang on — because clinical trials are making sure we’re well on our way.

Information on GRU Cancer Center’s clinical trials is available online at www.gru.edu/cancer/trials/. Or, contact the cancer clinical trials office directly at 706-721-2730 or 888-658-0422.

Dr. Samir N. Khleif is the director of the Georgia Regents University Cancer Center.