Cancer trials are a vital, yet often overlooked, treatment option

Keith S. Lanier, M.D.
Director, clinical research office
Providence Cancer Center

Published August 2012

As we know, formal clinical trials in cancer medicine help advance prevention, symptom management and treatment for people with cancer. Currently, our understanding of cancer cell molecular genetics and new targeted therapies is exploding; and clinical trials with new biologic endpoints will become more important as these therapies move from the laboratory to a standard of care.

At the same time, the national framework of federally funded clinical trial research is evolving. With the goal of reducing the burden of cancer in our populations, access to clinical trials is becoming easier, and the time between initiation and completion of trials is being expedited. We’re also seeing new collaborations with pharmaceutical companies as we study unique combinations of agents developed independently, but acting intracellularly within common pathways.

Reach a clinical trial coordinator
To learn about open research studies by type of cancer, contact one of the following coordinators:

Breast cancers
Katie Strauss, RN, OCN
503-216-8636

Colon, rectal, esophageal, liver, pancreatic and carcinoid cancers
Yue-Yun To, RN
503-215-2492

Lung, head and neck cancers
Brenda Fisher, RN, OCN
503-215-2613

Prostate, bladder, transitional cell, renal and testicular cancers
Scot Lary, RN
503-215-2604

Melanoma and brain cancers
Chris Fountain, RN, OCN
503-215-2691

Hematologic and gynecologic cancers
Laurie Delanty Miller, RN, OCN
503-216-3067

On a local level, it’s more important than ever for referring primary care physicians to work in concert with clinical trialists before initiating therapy. These partnerships enhance the understanding of clinical trials and ensure that more patients gain access to these advanced therapies.

A recent National Cancer Institute survey, however, found that only 2 percent of PCPs referring newly diagnosed patients to oncologists had discussed clinical trials with their patients. Thirty-seven percent of PCPs are unaware of the availability of clinical trials as an option for therapy.

A case for participation
More trials are addressing cancer treatments before surgical therapies, or as part of an orchestrated multimodality treatment plan. New targeted agents also are being used earlier to treat patients with advanced cancers for whom there is no established best standard of care.

Cancer prevention studies are important for those with increased risk of specific cancers. Large NCI-funded studies have been conducted on breast and prostate cancer prevention, and have led to recent approvals by the U.S. Food and Drug Administration for tamoxifen, raloxifene and finasteride.

An ongoing national polyp prevention trial is addressing risk of new colon polyps after successful surgical treatment for early colon cancer. Control studies evaluating therapies to reduce cancer treatment morbidities and improve quality of life are frequently offered in conjunction with cancer therapy trials.

Participants in clinical trials often have the opportunity to receive new agents in combination with the current standard of care treatment. A recent study found that those patients received excellent overall care and attention from their treating oncologist, as well as from the clinical trial and medical office staffs. 

Randomization within clinical trials is common, but the patient never receives care that’s inferior to the current best standard. The use of placebo in clinical trials is becoming less frequent, and independent data and safety committees are built into the trial process to ensure ethical and safe conduct.

With better collaborations and with anticipated improvements in the NCI clinical trial network, more people with cancer should participate in formal clinical trials. This will hasten the advances in cancer prevention, therapy and improved quality of life for our patients.