More Targeted Treatments Key to Progress in War on Cancer: Report
Major cancer organization also calls for streamlined clinical trials
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Thursday, November 3, 2011
THURSDAY, Nov. 3 (HealthDay News) -- More targeted treatments and streamlining clinical trials are among the keys to speeding the pace of progress in finding more effective cancer treatments, a new report says.On Thursday, the eve of the 40th anniversary of President Nixon's "War on Cancer," the American Society of Clinical Oncology (ASCO) released a report which pinpoints specific areas that need improvement to advance the cause of "personalized" cancer care.
"If we begin to make the needed changes, we believe that cancer research and patient care can become more targeted, more efficient and more effective," Dr. Neal Meropol, one of the three executive editors of the report, said at a teleconference. "We have a clear opportunity to accelerate the path of progress."
Tremendous progress has been made against cancer since President Nixon signed the National Cancer Act in December 1971, said ASCO President Dr. Michael Link. That includes a record number of cancer
survivors, a childhood cancer cure rate of 80 percent and a drop in death rates for many types of cancer.
Still, said Link, a pediatric oncologist at Stanford University, "We have a long way to go."
Researchers have learned that certain cancer drugs work very well in one person, but not in another because of differences in the genetic makeup of the tumor, among other factors. Far more needs to be learned about the molecular pathways and biomarkers that determine who will response best to a particular therapy, and how to best identify those patients.
In one scenario outlined in the report: an oncologist tells a patient he has kidney cancer. Instead of determining treatment based on where the tumor is located, the oncologist runs a genetic test on the patient and the molecular characteristics of the tumor to determine how likely the cancer is to spread, and which of the available medications will work best.
Though researchers are working to make those sorts of advances possible, progress is being hindered by a difficult-to-navigate regulatory maze and "years of under-funding" research, according to the report. Drug companies also lack incentives to share data and collaborate on research.
The blueprint recommends improvements in several key areas.
First, there's a need for developing new therapies based on a better understanding of cancer biology. That includes defining cancer based not just on where it's located in the body, but by the characteristics of the tumor itself and the "environment" the cancer is growing in, or the tissue around the tumor.
"We need to identify and prioritize molecular targets that have the greatest promise for improving survival," said Meropol, chief of hematology and oncology at University Hospitals Case Medical Center & Case Western Reserve University, Cleveland.
Also, more participants for clinical trials need to be recruited and more collaboration needs to occur between the research and industry communities to develop new combinations of drugs that could target multiple pathways at once.
Second is to focus on "smarter, faster clinical trials so that we can move quickly find out if new treatments are effective," Meropol said. Too many current studies are of the "me-too" variety which "don't have the potential to lead to major new advances in survival," he said.
Patients for clinical trials should be selected primarily based on the molecular characteristics of their tumors, said Dr. John Mendelsohn, co-director of the Institute for Personalized Cancer Therapy at MD Anderson Cancer Center in Houston.
Finally, the system needs to take advantage of innovations in health information technology such as electronic medical records as well as "rapid learning systems," that, among other things, could alert physicians and patients to relevant trials, Meropol said.
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