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Cincinnati On The Map For Latest Cancer Drug

By David M. Waterhouse, MD, MPH, medical oncologist and co-director of research, OHC, Blogs, For Physicians, 0 comments
August 18, 2015

Clinical Trials, Oncology Hematology Care, OHC, Cancer Treatment, Cincinnati Cancer Treatment, cancer, cancer help, cancer care

David M. Waterhouse, M.D., M.P.H., OHC Research Medical Director, is co-author of the Nivolumab study just published in The New England Journal of Medicine.

Radio, television, publications, even YouTube, are all talking about clinical research and the significant breakthroughs that have surfaced in the treatment of cancer over the last couple of years.

Cincinnati community physicians, their patients, and families have made significant contributions in the advancement of cancer treatment and we hope someday, the cure. I, along with my OHC colleagues, want to extend a sincere thank you for your support in promoting, educating, and encouraging your patients to seek all treatment options, including clinical research. Without a robust research program, today’s cutting-edge treatments would not be possible.

I would also like to give you a very brief, but important, update on a recently completed trial, as well as some of the ongoing trials that we offer here in Cincinnati. These efforts are literally changing the lives of cancer patients globally. It is not a mandate that our patients leave our community to receive top notch clinical trials; we are providing those opportunities every day and making a difference.

For example, OHC recently co-authored an article in the June issue of the New England Journal of Medicine. This study led to the approval of the first monotherapy for the treatment of squamous cell lung cancer in over a decade. The drug, anti-PD 1 agent Nivolumab (Opdivo), was approved three months ahead of the FDA’s scheduled decision date.

The New England Journal of Medicine article details how this randomized, open-label, international, phase III study evaluated the efficacy and safety of Nivolumab compared to Docetaxel in the treatment of patients with advanced squamous-cell non-small-cell lung cancer. Nivolumab nearly doubled the survival in this patient population while significant toxicities were reduced from 55 to only 7 percent.

The FDA rapidly approved Nivolumab because of the responses that the clinical trial enrollees had to this immune checkpoint inhibitor. You can read more here. You can also learn about our other clinical trials here.

J.P. Heiremans, an OHC patient and participant in an immune therapy clinical trial, remains on Nivolumab still after over two years. His life expectancy has significantly exceeded what we as clinicians would have historically seen with non-small cell lung cancer. Other immune checkpoint inhibitor studies are ongoing, with even more planned. OHC has firmly established itself as a Midwest regional leader in the development of these new therapies.

What’s New in Cancer Treatment and Research?

  • Next Generation Sequencing. Next Generation Sequencing allows the oncology team to have a better view of the patient’s specific cancer. Through this innovation, a targeted, personalized approach and treatment pathway can be developed to optimize the response and outcome. Next Generation Sequencing is a test that is performed from a patient’s tumor tissue. The tissue is then prepared by a pathologist and sent to the lab to undergo a test that matches over 315 genes. Upon completion of testing, OHC receives a detailed patient report. This report will display any “actionable” genetic alterations that have been discovered, possible FDA-approved drugs for the patient’s particular tumor, and any possible medications that are approved for treatment in another disease type. Additionally, the report will also display clinical trials that are available for the specific genetic alterations.
  • Personalized Medicine. We are utilizing Next Generation sequencing to identify genetic alterations within a patient’s tumor. This allows us to develop a treatment plan tailored to the patient. Just as no two people are alike, each cancer is unique.
  • New tumor specific targeted agents. Biomarker testing is allowing oncologists to target tumors that express specific markers that can be predictive of a drugs response. Such targeting potentially results in higher response rates while limiting toxicities.
  • Immunotherapy. There are treatments that use the body’s own natural defenses to fight cancer. Immunotherapy, also known as biotherapy or biological response modifiers, works on white blood cells – the body’s first line of defense against disease. White blood cells can be stimulated in various ways to boost the body’s immune response to cancer, with little or no effect on healthy tissue. Immunotherapy can also be used to lessen the side effects of other cancer treatments.

Some immunotherapies have received approval from the FDA for certain types of cancer. Others are being tested in clinical trials. Biological response modifiers are developed in a laboratory and then injected into the body. Side effects of immunotherapies can vary, but most exhibit similar symptoms, including fatigue, a rash or swelling at the injection site, and flu-like symptoms including nausea, diarrhea, and fever.

There are five general types of biological response modifiers. They can be used alone or in combination with each other, or they can be used in addition to other cancer treatments:

  1. Interferons are a group of three proteins released by white blood cells in reaction to invading organisms, to improve the immune system’s reaction to cancer. Interferon alpha is approved for treatment of some cancers, including melanoma and chronic myeloid leukemia, but is being studied for use on other cancers.
  2. Interleukins are proteins that increase growth and activity in the body’s immune cells. Ten interleukins have been identified so far, but IL-2 is approved as an anti-cancer treatment, particularly for kidney cancers and melanomas that have metastasized (spread) to other regions of the body.
  3. Monoclonal antibodies are created in the laboratory by fusing two different types of cells together. Monoclonal antibodies are designed to attack specific areas on the surface of cells known as antigens. Antigens help the body identify cells that are foreign, like germs or cancer cells, and stimulate an immune response. Monoclonal antibodies show significant promise both as a cancer treatment and a diagnostic tool.
  4. Vaccines help the body recognize cancer cells and trigger the immune system to destroy them. There are several types of cancer vaccines. Some contain cancer cells that have been killed with radiation so they cannot produce new tumors. Others contain lab-produced antigens designed to attach themselves to cancer cells. Cancer vaccines are used to either help the body reject cancer tumors or to keep them from recurring.
  5. Colony Stimulating Factors (CSF) work in the bone marrow, where red and white blood cells and platelets are produced. Colony Stimulating Factors increase the division of bone marrow cells, which strengthens the immune system and allows patients to endure higher doses of chemotherapy drugs.

I invite you to contact me or any of my colleagues with questions, concerns, or information about any of our clinical research drugs. As a team working together, we can and will make a difference in the lives of each and every patient we touch.

David M. Waterhouse, M.D., MPH
OHC Research Medical Director
Email: dwaterhouse@ohcare.com
Mobile: 513-673-1441


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