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2020 Cancer Guide

Understanding the value of clinical trials

Dr. Shirish Gadgeel, for Henry Ford Health System
While cancer clinical trials often open the door to promising new treatment options that help patients live longer – especially those with advanced cancer diagnoses – fewer than 5% of eligible adult patients in the U.S. are enrolled in one.

Cancer is a difficult disease to treat, and clinical trials are an extremely important aspect of medicine for creating new treatment guidelines. Almost everything done today – from cancer screening to palliative care – was established because of a clinical trial. In recent years, clinical trials determined the benefits of CT scans for lung cancer screening. Also, many new cancer drugs – including those used in immunotherapy and targeted therapy – have gone through multiple clinical trials and are approved for treatment for various cancers.

According to a recent study in the New England Journal of Medicine, new drugs and treatments have contributed to a 6% decline in lung cancer deaths between 2013 and 2016. With these advances, a small percentage of my patients with advanced lung cancer are surviving up to 8 to 10 years after their diagnosis. But our goal is to help many more patients.

Dr. Shirish Gadgeel is division head of Hematology/Oncology and associate director for Patient Experience and Clinical Care at Henry Ford Cancer Institute.

Before a possible cancer drug can be entered into a clinical trial, many years of extensive testing must be done in laboratories and animal models. These tests minimize the risk of significant side effects and improve the chances of the drug being successful.

It’s important to know that cancer processes itself differently in children and adults of various ethnic and racial groups. The sad news is that only 3% to 5% of eligible adult patients in the U.S. are enrolled in cancer clinical trials. So, it is extremely crucial to enroll more adult patients, particularly those who are in ethnically and racially diverse populations.         

One example involves triple negative breast cancer. It is associated with a higher mortality rate in African American women, but, unfortunately, African American women are under-represented in clinical trials. If we were able to increase adult participation in clinical trials, we could treat cancer much more effectively in the coming years.            

There are immediate advantages of clinical trials, especially for patients with advanced cancer. Several cancer experts are involved in the process of developing each clinical trial. So, in a sense, the patient is receiving a second opinion from several doctors with expertise in his or her cancer. Also, there is the possibility of obtaining access to a drug that is currently experimental and may not be available otherwise for many years.

 At Henry Ford, there are more than 100 clinical trials for various types of cancer. My work includes 15 to 20 clinical trials for lung cancer and about 5 to 6 clinical trials that are considered early phase or first-in-human clinical trials. Some of our trials address rare genetic alterations found in only 0.2% of certain cancers. Not all laboratories can identify these rare genetic alterations, but Henry Ford Cancer Institute’s molecular pathology laboratory has developed tests to identify them.

Our goal is to participate in clinical trials that match the capabilities of our molecular pathology and precision oncology programs and to provide our cancer patients the most effective therapy. Although it is impossible to enroll every patient in a clinical trial, we believe every patient should be considered for one.

About the expert

Dr. Shirish Gadgeel is division head of Hematology/Oncology and associate director for Patient Experience and Clinical Care at Henry Ford Cancer Institute.

Members of the editorial and news staff of the USA TODAY Network were not involved in the creation of this content.
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