Cancer clinical trials can be a good treatment option. Today I’m giving a signal boost to a great post on CURE Today by my amazing clinical trial oncologist, D. Ross Camidge, MD, PhD, at University of Colorado. He’s written a nice overview of the benefits and pitfalls of cancer clinical trials for patients.
Reality check: No one is hiding THE ONE CURE for cancer.
There will not be one treatment to cure all cancers, because each case of cancer is as unique as the person whose cells mutated to create it.
We’ve been curing cancer in groups of mice and lab containers for decades. However, the human body–and therefore each cancer it generates–is more complicated than a mouse or cells isolated in a petri dish.
Each cancer is a unique living organism that can mutate and evolve over time. Just like its host, a cancer’s characteristics and behaviors are influenced by genetics, environment, nutrition (what it consumes to make energy), and exposure to infectious diseases and toxins (and probably other factors we haven’t discovered yet).
If anyone had run a study in humans that proved a single cure worked for every case of cancer, no one could hide it. No one could silence the millions of joyful, grateful patients who had been cured by it.
Enough with the cancer conspiracy theories, people. Accept that humans–and cancer–are complicated creatures, and get on with the research. We cancer patients are waiting, and we don’t have the luxury of time.
If you have been diagnosed with advanced non-small cell lung cancer (NSCLC), please read this blog post. It could buy you months or years of good living. Lung cancer treatments are advancing so fast that your cancer doctor may not know this information–even if they are at a major academic cancer center.
Scientific evidence is accumulating that genomic testing and targeted therapies for cancer patients who have advanced non-small cell lung cancer make a significant difference in outcomes. By “significant difference,” I mean a year or more of survival with good quality of life. Genomic testing and a targeted therapy have given me no evidence of disease for four years despite my metastatic lung cancer. Now THAT’s is a significant difference!
Genomic testing looks at the cancer cells DNA for alterations in certain genes that may be driving the cell to act like cancer. FDA-approved drugs are available that can target some of these driver genes (EGFR, ALK, and ROS1) and inhibit the cancer–these drugs are called “targeted therapy.” Targeted therapy for other driver genes are available through clinical trials. These drugs do not cure, but they are usually more effective and more tolerable than chemo. Not every NSCLC cancer will have a driver gene, and not every driver gene has an effective treatment. However, it’s worth investigating, because about 60% of NSCLC adenocarcinoma patients likely DO have a driver gene that can be targeted with an approved or experimental drug (per the LCMC II study).
Guidelines from the College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association of Molecular Pathologists (AMP) recommend analyzing either the primary NSCLC cancer tumor or a metastatic tumor for EGFR and ALK, regardless of patient characteristics (such as age, race, or smoking history). The National Comprehensive Cancer Network guidelines for metastatic non-small cell lung cancer strongly recommend testing for alterations in EGFR, ALK, and ROS1 genes, as well a broader genomic panel to look for driver genes that might have clinical trials available.
A recent article is a great reference on this subject for both physicians and for patients who want to learn more about their options. It discusses evidence-based molecular testing options, driver genes, and available targeted therapy options, including off-label use of FDA-approved drugs for patients whose cancer mutation does not yet have an approved treatment. It also provides references to professional society guidelines and key journal articles. The authors are Lecia V Sequist, MD, MPH (Associate Professor of Medicine, Harvard Medical School–an EGFR superdocs and a member of LUNGevity’s Scientific Advisory Board) and Joel W Neal, MD, PhD (Assistant Professor of Medicine–Oncology, Stanford University/ Stanford Cancer Institute).
Those of you with advanced NSCLC might want to share the article with your cancer doctor.
Personalized, genotype-directed therapy for advanced non-small cell lung cancer by Lecia V Sequist, MD, MPH, and Joel W Neal, MD, PhD
Research and new treatments are moving faster than most cancer physicians can track. Patients with advanced NSCLC can increase their chances of survival if they learn more about their disease. I hope this blog helps you do that.
Hope you will join the lung cancer community tomorrow 11/17 at 8pm Eastern for the first-ever Lung Cancer Awareness Month Facebook Live event with the National Cancer Institute and the concurrent Lung Cancer Social Media (#LCSM) Chat on Twitter. We’ll be talking about immunotherapy and lung cancer clinical trials.
For more information, check out the Lung Cancer Social Media (#LCSM) Chat blog post for their 11/17/2016 chat.
Hey ROS1ers: This is an IMPORTANT REQUEST!
We all want to find a CURE for our disease, right?
To do this, we need to know how many patients are willing and able to participate in research for cancer driven by ROS1 mutations. The results will hopefully motivate more patients to join us, generate more interest in collaborative ROS1 research, and attract more funding to ROS1 research.
PLEASE COMPLETE THIS BRIEF 10-QUESTION POLL AS SOON AS POSSIBLE. Just click on the link below to get started! It only takes about 5 minutes. Results of the poll will be posted on the ROS1cancer website, and the Bonnie J. Addario Lung Cancer Foundation (ALCF) ROS1 website.
If you haven’t already, please complete the ROS1 patient survey on the ALCF ROS1 website. We need more responses–COMPLETE responses (all questions answered)–to have statistically valid data. It’s a long survey (might require an hour), but the length is necessary to accomplish its goals. The survey examines ROS1 patients’ diagnosis and treatment journey, family cancer history, patient exposure to toxic environments and materials, and other factors that might have contributed to the development of ROS1 cancer. A poster about the survey was presented at the IASLC Chicago Multidisciplinary Symposium In Thoracic Oncology in September 2016. The preliminary results of the survey will be presented at the IASLC World Conference on Lung Cancer in Vienna in early December 2016.
Four years ago today, I took my first dose of crizotinib in a clinical trial for patients who had ROS1-positive lung cancer. My first scan–and every scan thereafter, including this past Monday 10/31– has shown no evidence of disease (NED). Not bad for a metastatic lung cancer patient who previously progressed on two separate lines of combined chemo and radiation.
I’m very grateful for cancer research and the availability of clinical trials. We’ve had more new drugs approved in the past five years than in the previous five decades!
During November, which is Lung Cancer Awareness Month (#LCAM on Twitter), please consider donating to your favorite lung cancer research facility (one option is the Lung Cancer Colorado Fund at the University of Colorado) or a lung cancer advocacy organization that supports research.
And for a bit of hope, check out the NEW LCAM website, which represents a partnership among 19 lung cancer advocacy organizations led by the International Association for the Study of Lung Cancer (IASLC).
HOPE LIVES! More research. More survivors.
If you’re a patient or caregiver dealing with EGFR-, ALK-, or ROS1-positive lung cancer, please consider attending the GRACE forum in Denver this August. You’ll learn tons about the latest treatment options and trials, diagnostic tests, and tips for living with cancer as a chronic illness from experts like Dr Ross Camidge (my research oncologist at University of Colorado who started their remote consult program) and Dr Dara Aisner (co-director of CU’s molecular pathology lab that does the tissue testing). Patients Linnea Olson , Tori Tomalia, and Bob Fuerst are on the program, too! If I didn’t have vacation plans with my son, I’d be there for sure.
You can register here: http://cancergrace.org/targeted-therapies-in-lung-cancer-patient-forum-2016-denver-co