Cancer Commons is teaming up with eight other healthcare innovators to form the Oncology Clinical Trial Information Commons (OCTIC), a shared platform that will improve cancer patients’ access to information about clinical trials.
The OCTIC platform will store information about clinical trials and make it accessible for patient matching and other data mining. According to a press release from the Biden Cancer Initiative, “the system will employ a single set of terms and rules, and a user-friendly interface for biopharma companies to readily enter and update their trials. The information will include patient selection criteria, trial locations, and patient participation requirements, all in a consistent, machine-readable format.”
Martin Naley of the Biden Cancer Initiative wrote in a Medium post, “The program is intended to be compatible with all parts of the clinical trials ecosystem. It can be the single point of data entry for clinical trial sponsors and investigators. Government registry programs can read directly from it, making them better. Patient advocacy organizations, health institutions, and technology developers can connect to it in order to power their services. OCTIC won’t compete with anyone; rather it will make many parts of the oncology clinical trial ecosystem more efficient.”
We’re thrilled to be part of this important project and look forward to working closely with our innovative collaborators.
A Q&A with Martin Brown D.Phil, FASTRO, Emeritus Professor, and Lawrence Recht, MD, Professor, at Stanford University’s Department of Neurology
Q: The treatment of glioblastoma multiforme (GBM) is a serious challenge. Recurrence after initial surgery is common and subsequent treatment almost always unsuccessful. Just as “an army marches on its stomach,” GBM growth depends on blood supply. Successful use of the FDA-approved drug plerixafor (Mozobil) combined with irradiation for mouse model gliomas some years ago has lead to clinical trials in human GBM.
What is the current status of these investigations, and how could our readers help the effort?
A: A little over ten years ago, Dr. Brown began a series of preclinical studies to test the possibility that an important contributor to the recurrence of malignant brain tumors after radiation therapy was reconstitution of the tumor vasculature. Specifically, he hypothesized that this reconstitution stemmed at least in part from circulating pro-angiogenic cells not in the tumor at the time of radiation—a phenomenon known as “vasculogenesis.” In agreement with this concept, a finding common to all of the tumor models he tested was a major influx into the irradiated tumors of bone marrow-derived cells, most of which were macrophages, that correlated with when tumors began to grow two to three weeks after completion of radiation. Further, he demonstrated that the mechanism for this influx was a radiation-induced hypoxia that triggered a cascade that led to the secretion of stromal cell-derived factor-1 (SDF-1), which was instrumental in attracting these cells. The apparent importance of excluding these cells’ entry into tumors post-irradiation suggests a new treatment strategy, which we call macrophage exclusion radiation therapy (MERT). Continue reading…
It has been over a year since I last wrote about new developments in treatment of melanoma, and it is time for an update. There is certainly some good news for melanoma patients!
Neoadjuvant (before surgery) treatments for resectable melanoma
Stage III—and more rarely, stage IV—melanoma tumors that have not spread widely can be sometimes treated surgically. Last year a small clinical trial showed that, in BRAF-mutant melanoma, treatment with the BRAF/MEK inhibitors dabrafenib and trametinib (D/T) before and after surgery provides a significant improvement over just post-surgery treatment, by preventing later recurrence.
Later in 2018, researchers reported that using the immune checkpoint drugsnivolumab and ipilimumab prior to surgery led to tumor reduction in 73% of patients treated in a clinical trial. After surgery, they remained disease-free for 2 years (the reported time of observation). Treatment with nivolumab alone was not nearly as active in this randomized trial, with only 25% of patients responding to neoadjuvant nivolumab; still, 75% were disease-free within the 2-year observation period.
An interesting trial tested a single dose of the drug pembrolizumab given three weeks prior to surgery. Of 27 patients who received this single infusion, eight (29%) had a complete or major pathological response, meaning that their tumors were reduced by 90% or more. These eight patients continued on pembrolizumab after surgery and were disease-free for over 2 years. Continue reading…
“An experimental drug has shown promise in extending the lives of women suffering from a particularly aggressive and deadly type of breast cancer, according to the results of a phase 2 trial.
“Right now, the standard treatment of chemotherapy for metastatic triple-negative breast cancer has not been very effective. That might change with the new drug, called sacituzumab govitecan, which combines an antibody with a chemotherapy drug to better target cancer cells.”
“The targeted radiation therapy Lutetium-177 PSMA-617 produced high response rates among men with prostate-specific membrane antigen-positive metastatic, castration-resistant prostate cancer, according to results of a single-arm, phase 2 trial scheduled for presentation at Genitourinary Cancers Symposium.
“The treatment also appeared well-tolerated among these men, whose disease had progressed after multiple standard therapies.”
“The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs).
“The trial previously tested treatments for people with advanced-stage squamous cell lung cancer. Opening the trial to all types of advanced-stage NSCLCs means that thousands of new patients will be eligible to enroll.”
“Aggressive local consolidation in stage IV non-small lung cancer (NSCLC) drastically improved overall survival over standard care in patients with up to three metastatic lesions, a small randomized study found.
“Among 49 patients whose disease had not progressed after initial systemic therapy, overall survival was 41.2 months in those treated with radiotherapy or surgery compared with 17.0 months in those on standard maintenance therapy (P=0.017), reported Daniel Gomez, MD, of MD Anderson Cancer Center in Houston, at a press briefing here at the American Society for Radiation Oncology (ASTRO) meeting.”
“An experimental cancer drug that Novartis hopes will raise the profile of its oncology portfolio cut the risk of death or disease progression by more than a third in breast cancer patients with a hard-to-target gene mutation.
“The Swiss drugmaker’s BYL719, a so-called PI3K inhibitor also known as alpelisib, combined with hormone therapy fulvestrant boosted median progression-free survival (PFS) to 11 months, up from 5.7 months for patients who got only hormone therapy, the company said on Saturday.”
“Combination neoadjuvant immune checkpoint blockade therapy yielded promising outcomes in high-risk resectable melanoma, although toxicity was an issue, according to a phase II trial.
“The combination of ipilimumab (Yervoy) and nivolumab (Opdivo) led to improved progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS) versus neoadjuvant nivolumab monotherapy in 23 patients with high-risk resectable melanoma, reported Jennifer A. Wargo, MD, of MD Anderson Cancer Center in Houston, and colleagues in Nature Medicine.”