the importance of clinical trial participation for patients with cancer and highlights the use of precision medicine across the treatment armamentarium

Dr Hochster on the Importance of Clinical Trial Participation in Cancer Care

Howard S. Hochster, MD, distinguished professor of medicine, associate director, Clinical Research, director, Gastrointestinal Oncology, Rutgers Cancer Institute, director, Oncology Research, RWJ Barnabas Health, discusses the importance of clinical trial participation for patients with cancer and highlights the use of precision medicine across the treatment armamentarium.

The process of advancing care in oncology has always been reliant on clinical trials, Hochster begins. Every currently available drug owes its presence on the market to a clinical trial, though not all drugs that undergo testing prove effective, Hochster states. The assurance is that any available drug that demonstrates efficacy has undergone rigorous investigation in clinical trials, he emphasizes. When communicating with patients, Hochster imparts that participating in a clinical trial provides patients with an opportunity to access tomorrow's treatment today.

For oncologists, it is crucial to comprehend the specific benefits and potential adverse effects (AEs) associated with new drugs, whether used independently or in conjunction with standard therapy, Hochster expands. The optimal utilization of these drugs is discerned through prospective randomized clinical trials, where investigators glean essential information, he states. Cancer therapy has transformed significantly over the past few decades, Hochster adds. The treatment paradigm was initially dominated by broad-spectrum chemotherapy, which, although effective against cancer cells, also affected healthy cells and was associated with substantial AEs, Hochster explains.

Over the last 50 years of unraveling molecular biology and understanding cellular behavior, investigators have identified the weaknesses and vulnerabilities of cells, he continues. Targeted therapy now allows for a more precise eradication of cancer cells, promoting longer patient life with fewer AEs. With a deep understanding of the underlying tumor biology, investigators can often identify biomarkers indicating which patients will benefit from a specific drug based on the presence of a certain mutation or the overexpression of a particular pathway or molecule, Hochster emphasizes. This personalized approach, often termed precision medicine, employsthe testing of specific genomic changes to administer the optimal drugs to individual patients, Hochster concludes.

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Howard S. Hochster, MD, discusses the importance of clinical trial participation for patients with cancer and highlights the use of precision medicine across the treatment armamentarium.

Howard S. Hochster, MD, FACP, associate director of clinical research and director of gastrointestinal oncology at Rutgers Cancer Institute of New Jersey, director of oncology research for RWJBarnabas Health, and attending physician at Robert Wood Johnson University Hospital, discusses treatment considerations for patients with HER2-positive gastric cancer.

Various therapeutic options are currently available for patients with gastric cancer. Determining whether a patient has HER2 overexpression is important, even though its presence is less common in gastric cancer compared with breast cancer, according to Hochster. For these patients, anti-HER2 drugs can be utilized either as monotherapies or in combination with other agents, Hochster says.

Immunotherapy has become part of the paradigm for use in either the first-line or maintenance setting in patients with gastric cancer, Hochster adds. Patients who have high PD-1 expression can derive a good deal of benefit from immunotherapy, Hochster concludes.

Howard S. Hochster, MD, FACP, discusses treatment considerations for patients with HER2-positive gastric cancer.

Dr. Hochster on Treatment Considerations for HER2+ Gastric Cancer

Howard S. Hochster, MD, FACP, associate director for clinical research and director, Gastrointestinal Oncology, Rutgers Cancer Institute of New Jersey, director of oncology research, RWJBarnabas Health, discusses important takeaways from the randomized, double-blind, phase III POLO trial in pancreatic cancer. 

Investigators reported a progression-free survival benefit with olaparib (Lynparza) as maintenance therapy for patients with germline 

-mutated metastatic pancreatic cancer who had not progressed during first-line platinum-based chemotherapy.

From this study, Hochster concludes that global genetic testing for germline 

-mutated disease should be implemented. Although 

 mutations are found in about 8% of all patients with pancreatic cancer, certain subgroups have a higher incidence.

Taking a thorough family history is also important, says Hochster. A patient with a family history of breast or ovarian cancer who develops pancreatic cancer should be tested for a 

 mutation to determine if they could benefit from treatment with olaparib.

Howard S. Hochster, MD, FACP, discusses important takeaways from the randomized, double-blind, phase III POLO trial in pancreatic cancer. 
 

Howard S. Hochster, MD, FACP

Articles

Dr Hochster on the Importance of Clinical Trial Participation in Cancer Care

Dr. Hochster on Treatment Considerations for HER2+ Gastric Cancer

Dr. Hochster on Take-Home Message of the POLO Trial in Pancreatic Cancer