Recent treatment advances
Recent advances in medical research have led to a shift in understanding the molecular and immunological biology of cancers, leading in turn to the creation of new therapies. Many treatments developed in common cancers have also been shown to work in uncommon cancers. At the same time, we no longer have to think about cancers in terms of where the cancer is and can treat patients according to their genetic features.
Targeted treatments aim to restrict tumour growth and immunotherapies look to stimulate our immune responses to destroy tumours. For the first time, we have a real opportunity to improve the outcomes for patients with less common, high-mortality cancers across Australia.
Barriers to improved outcomes
Although this kind of genomic cancer research is making great progress, research into high-mortality cancers is unfortunately underfunded compared with breast, prostate and bowel cancer research.
The cost of drug development and the challenges of conducting clinical trials with the small patient groups means that these cancers are often neglected and under-represented in clinical trials. This can have fatal consequences given that government-approved and reimbursable treatments are generally based on clinical trial evidence.
There are two key barriers to improved outcomes for less common cancers:
- Access to clinical trials
Basic knowledge from research and from clinical trials is essential if we are to improve the therapeutic options for patients with less common, high-mortality cancers. There is excellent evidence that participation in clinical trials is associated with better outcomes.[1]
- Access to the best available treatments
As governments use information from trials when deciding if they will fund a new drug, it is critical that patients with less common cancers have access to clinical trials, and that government, academics, clinicians and the pharmaceutical industry work together to develop trials for these cancers, as well as the more common cancers.
At Garvan, Professor David Thomas, Director of The Kinghorn Cancer Centre and Head of Genomic Cancer Medicine, and his colleagues, have devised the MoST Clinical Trials to provide new treatment options for less common cancers.
[1] Maria Schwaederle 1 , Melissa Zhao 1 , J Jack Lee 2 , Vladimir Lazar 3 , Brian Leyland-Jones 4 , Richard L Schilsky 5 , John Mendelsohn 6 , Razelle Kurzrock 7, ‘Association of Biomarker-Based Treatment Strategies With Response Rates and Progression-Free Survival in Refractory Malignant Neoplasms: A Meta-Analysis’; JAMA Oncol 2 (11), 1452-1459. 2016 Nov 01. JAMA Oncol doi:10.1001/jamaoncol.2016.2129 Published online 6 June 2016.
