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
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.
To see the progress that has already been made against cancer,
Society of Clinical Oncology.