Mercy Offers a Nationwide Cancer Trial
authors Christine Imbs
Most cancer treatments focus on where the cancer is located in the body, but a new National Cancer Institute (NCI) trial is looking at the disease in a completely different way – by what specific gene abnormality may have caused the cancer in the first place, regardless of what organ it’s affecting.
The Molecular Analysis for Therapy Choice (MATCH) precision medicine trial is now available to patients at Mercy Hospital St. Louis along with hospitals in Springfield, Bolivar, Branson and Joplin across several hospital systems as part of the Cancer Research of the Ozarks’ participation in ongoing NCI studies.
“It’s cutting edge,” said Jay Carlson, DO, director of women’s oncology at Mercy Springfield and the principle investigator for Cancer Research of the Ozarks. “It’s the next generation of cancer treatment and being able to offer it to our patients is exciting.”
The trial is for patients who have either exhausted conventional treatments, or who have a rare or particularly aggressive form of cancer. “It offers them new hope because now there is another option to consider,” said Carlson.
Currently, the two most common treatments for cancer are chemotherapy and radiation. Both work by destroying fast-growing cancer cells. Unfortunately, they also damage fast-growing healthy cells as well. In this trial, they are looking at somatic mutations and gene abnormalities within the cancerous tumor and then matching them with certain drugs coming through NCI. Right now the trial is studying 10 drugs and 12 more are on the way.
“Patients have never seen these drugs before,” Carlson said. “In many cases, they’re in tablet form so patients won’t have to wait through long infusions in a clinic. They can medicate themselves at home.”
And they won’t have to deal with the side effects of chemotherapy and radiation such as hair loss, nausea, vomiting and blood count issues. Of course that’s not to say there won’t be any side effects. Diarrhea and rashes may occur as well as some other reactions. Since the drugs aren’t FDA approved, the jury’s still out on this subject. But Carlson is optimistic.
“We’re damaging all kinds of normal cells in addition to the cancer cells with chemotherapy and radiation. So the idea that we would be able to have a smart drug, like a smart bomb, be able to hit a mutation with laser accuracy is very cool,” he said. “It’s a great opportunity for our patients. Hopefully this is the first step toward much more therapeutic treatments than just standard chemotherapy.”
Potential candidates for the trial must be 18 years of age or older with either an extremely advanced malignancy where they have limited options, or who have exhausted their options. And, according to Bethany Sleckman, MD, Mercy Clinic medical oncologist and director of oncology research at Mercy Hospital St. Louis, they must also have a new biopsy taken so the tumor cells can undergo genetic testing to determine whether or not they contain one of the gene mutations being studied.
“We can’t just rely on previous biopsies because as cancer grows and spreads, it can develop new mutations,” she explained. “We want a clear picture of what the mutations are in the cancer at the point that we’re going to enroll them in the trial.”
Sleckman also said they are screening for over 100 different genetic mutations in the tumor. “We’re looking for all mutations in any kind of cancer because more and more we’re finding that cancers can have different mutations not necessarily correlated to the original site of the disease.”
The National Cancer Institute’s goal is to enroll 3,000 patients in the initial biopsy phase of the trial. Originally they expected to enroll 500 the first year nationwide, but by the second month of the trial that number was already reached.
“Clearly, this trial is very popular with both physicians and their patients,” said Sleckman. “And it’s really nice, especially here at a community hospital, to be able to participate in studies sponsored by the NCI. It keeps our physicians on the cutting edge of therapy and offers that cutting edge therapy to our patients closer to home.”
Of course to be part of the trial, a patient has to quality. And that’s the downside. To find those 3,000 patients who actually receive one of the drugs, they may have to go through 20,000 hopeful applicants. As Carlson said, if enrolled in this program, they could “potentially find a homerun solution for them.” If not, it’s devastating.”
“It’s a lot to think about,” he said. “They have this hope dangled in front of them and then it’s yanked away when the results show there is a mutation, but just not one in the first 22 drugs we’re doing. That’s why it’s important to talk with your oncologist to be sure you are a potential candidate.”