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.