Commentary: Clinical trials help advance both the present and future of medicine
If you’ve ever used a medication to treat an illness, you have a clinical trial to thank for it.
Every standard therapy used in medicine today once started as a clinical trial — and it is commonly understood that today’s trials are shaping treatments of the future.
Less understood is the fact that clinical trials are helping patients right now.
From pancreatic cancer patients whose lives are extended far beyond current expectations, to patients with metastatic cancer who are taking back control of their lives, clinical trials are providing people in our community today with hope, help and healing.
As a physician involved in various clinical trials at Hoag Family Cancer Institute, I am witnessing a remarkable evolution in medicine. Myself and my colleagues are using immunotherapy to “reprogram” patients’ immune systems to fight cancer on their own. We are injecting chemotherapy directly into tumors to shrink cancer while minimizing risk to a patient’s healthy tissue, and we are using state-of-the-art genomic testing of tumors to develop more targeted and effective treatments.
Already, we are seeing impressive results, as clinical trials being conducted right here in Newport Beach are leading to safer, more effective and longer-lasting cancer treatments.
There is a persistent misconception that early phase clinical trials simply collect safety data and don’t actually help patients, but that isn’t the case at all.
Clinical trials have advanced to the point that the early phase trials are now leading directly to U.S. Food and Drug Administration-approved treatments. At Hoag, we won’t engage in trials unless we believe they have the potential to immediately help our patients.
They also are designed to be safer than in the past. Any drug that makes it to a human clinical trial has already been through years of laboratory studies. Millions of dollars of research and countless hours of work have gone into making the treatment safe for humans.
That is part of the reason why today’s clinical trials lead to FDA approval much faster than trials of the past. By offering targeted and better-designed drugs, we can see a “home run” in a much earlier phase of a clinical trial.
We saw exactly this type of success late last year, when the FDA granted accelerated approval of larotrectinib — a treatment for cancers that have a specific genomic feature. In trials, the drug had a 75% overall response rate across different types of solid tumors. Some of the cancers treated by larotrectinib include soft tissue sarcoma, salivary gland cancer, infantile fibrosarcoma, thyroid cancer and lung cancer.
Patients benefited from these trials, and they are continuing to benefit. Deborah McCartney, whose Stage 4 lung cancer had aggressively spread to her brain, lungs and lymph nodes, told us she entered a clinical trial offering an experimental drug at Hoag because she wanted access to the most modern medicine possible.
Deborah echoed what we firmly believe: Standard treatments we offer today are not good enough — how can they be? We know that “tried and true” works, but the level of pain patients experience on the road to recovery, the recurrence rates and deaths tell us that we are not done striving.
When she entered the clinical trial, Deborah discovered a layered and rigorous process led by a thoughtful, experienced and specialized team. Oversight and safety inform everything we do. Our team includes a clinical research director, program manager, clinical research nurses and clinical research coordinators. We are adding new trials and growing our program continuously.
Historically, the only treatment options for cancer were surgery, radiation and chemotherapy — your all-purpose cancer poison. Thanks to clinical trials, we are now entering an era that is more focused and sophisticated.
In the coming years, precision medicine, immunotherapy and injectable therapies will take over where standard treatments have left off. We will have a tighter grip on cancer, a smarter approach to treatment and better, longer-lasting results.
And you’ll have clinical trials to thank for it.
Dr. Jacob Thomas is a medical oncologist at Hoag Hospital with special training in early phase clinical trials.
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