The daily goal of oncologists at Willamette Valley Cancer Institute and Research Center in Eugene is to outsmart cancer and save lives. Cancer research plays a significant role in both.
“We have these two goals with every patient, to maximize both the patient’s quantity of life but also the quality of life,” says Dr. Jeff Sharman, WVCI Director of Research. “Clinical trials are really the life blood of how we are going to make progress in treating cancer.”
What are clinical trials?
Clinical trials are research studies that help doctors determine whether new treatments are safe and effective and work better than current treatments. Clinical trials also help discover new ways to prevent and detect cancer.
“I think there’s a common misperception that clinical trials are only suitable for those patients running out of treatment options. That’s really not the case at all,” says Dr. Sharman. “Clinical trials can be relevant to any stage of cancer treatment and, in many ways, are looking to advance: how do we make this step better? That can be patients who are newly diagnosed, or it could be patients who have had prior therapy.”
Two exciting areas of cancer research are focused on immunotherapies and targeted therapies. Immunotherapy works by boosting a person’s own immune system to fight the cancer, while targeted therapy uses drugs that target specific parts of cancer cells to help stop them from growing and spreading.
“In many cases, cancer is the accumulation of too many ‘on switches’ that are stuck on and too many ‘off switches’ that are inactivated. Some of these cancers are addicted to these growth switches being turned on—when you turn them off, you can really see profound changes for individual patients.”
Clinical trials have also identified therapies called PARP inhibitors that are proving effective in treating several types of cancer, including ovarian cancer. When cancer cells are damaged by chemotherapy, they require an enzyme called PARP to repair themselves. PARP inhibitors block that enzyme, causing the cancer cells to die.
PARP inhibitors fight cancers caused by mutations in BRCA1 and BRCA2 genes, which account for about 20 to 25% of hereditary breast cancers and 15% of ovarian cancers. These drugs have also been shown to be effective in treating somatic mutations, those that reside inside the tumor and may not be genetically inherited.
Dr. Charles Anderson leads the WVCI gynecologic cancer research team. “The combination of drugs that we’re looking at now are very likely to extend the life of many patients who, historically, would have succumb to their disease within 3-5 years,” he says. “They will now likely still be alive at that 10-year mark, and we’re already starting to see that.”
In addition to advancing new treatments for cancer, clinical studies are also used to identify ways to better detect the disease. WVCI is one of many centers nationwide that is currently enrolling patients in the PATHFINDER research trial, studying a new type of blood test that could identify signs of cancer at much earlier stages, as well as its possible location in the body. This information could help healthcare providers determine the appropriate tests to confirm whether cancer is present.
Knowing all that you can about clinical trials can help you feel more certain when deciding whether to take part in one. Check out this list of frequently asked questions.
How are clinical trials conducted?
Clinical trials are conducted in a series of steps, called phases, and each phase is designed to answer a separate research question.
Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range and identify side effects.
The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects and compare it to commonly used treatments.
Placebo-controlled or randomized trials
A placebo-controlled trial is a study in which the effect of a drug is compared with the effect of a placebo (an inactive substance designed to resemble the drug). A common concern of patients considering a clinical trial is that they will receive a placebo instead of the drug being tested.
“Placebo-controlled studies are very rare in oncology,” says Dr. Sharman. “Randomized trials are much more common.”
In a randomized controlled trial, participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best.
Treating patients close to home
Through its affiliation with the U.S. Oncology Network, one of the largest cancer treatment and research networks in the country, Willamette Valley Cancer Institute is able to offer local patients access to national and global clinical trials close to home.
Not every patient qualifies for a clinical trial, and not every trial drug works for every patient enrolled in a study, but those who participate are the first to benefit when the treatment is effective. Lean more here.
“Our goal is to make cancer a chronic disease, and new things are being developed every day,” says Dr. Marc Uemura, a medical oncologist at WVCI. “Patients have more of a variety of options for cancer therapies and that, in itself, does provide more hope.”