6 minute read
Precision Cancer Therapies
The Medicine of Tomorrow, Today
Precision Cancer Therapies Program offers hope through groundbreaking treatments
By Anne Paglia | Photos: Stephen Legendre
For decades, a cancer diagnosis meant chemotherapy treatment would shortly follow. Today, however, some patients have an alternative—thanks to precision medicine. Ochsner Health’s Precision Cancer Therapies Program (PCTP) has offered hundreds of patients this life-saving option.
Established in 2017, PCTP provides cancer patients a chance to receive some of the most innovative drugs available by participating in phase 1 clinical trials. PCTP is one of the only phase 1 cancer programs in the region, filling a critical need for residents of the Gulf South.
“The program provides new, often experimental, drugs to cancer patients who don’t have a lot of other options,” said Marc Matrana, MD, System Director for Precision Medicine at Ochsner. "In many cases, these treatments are very effective because they're paired using precision medicine. We like to say that they're receiving the medicine of tomorrow, today."
Oncologists trained in precision medicine start by genetically sequencing a patient’s cancer tissue or DNA. With the results, they can identify the genetic mutation causing the cancer and target it with the most effective therapy. These individualized treatments are more precise, tend to produce better outcomes and cause fewer side effects than chemotherapy, which kills healthy and cancerous cells alike.
Burke J. Brooks, MD, System Vice Chair of Hematology and Oncology at Ochsner
Photo Credit: Stephen Legendre
“Chemotherapy is a very blunt instrument,” said Burke J. Brooks, MD, System Vice Chair of Hematology and Oncology at Ochsner. “It works for many cancers, but we’re trying to find more precise treatments with fewer side effects. Precision medicine—what we’re doing today—is advancing that dramatically.”
- Marc Matrana, MD
Finding the root of the problem
Traditionally, doctors have defined cancers according to their sites of origin in the body. But scientific developments have shown that it’s more advantageous to think about cancer according to its molecular makeup. “If two cancers have the same molecular markers, they’re treated the same, whether they started in the colon or the stomach,” Dr. Brooks said. “The site of origin doesn’t make a difference. Today we’re pushing to have all of our patients’ cancers molecularly defined so we can look for those specific genetic abnormalities that lead to more precise, better treatments.”
For example, doctors previously viewed non-small cell lung cancer (NSCLC) as a single disease. Every patient with NSCLC was treated the same way with chemotherapy. In recent years, however, they’ve come to understand NSCLC as dozens of different diseases, each one defined by its own underlying mutation.
“When we find those underlying mutations upfront and treat them rather than just the cancer itself, patients do far better,” Dr. Matrana said. “They have a far better quality of life, live longer, and have fewer side effects. Non-small cell lung cancer has become the poster child of precision medicine because it’s such a big part of treating this disease now.”
Marc Matrana, MD, System Director for Precision Medicine at Ochsner
Photo Credit: Stephen Legendre
While there are already drugs on the market that target a number of NSCLC’s underlying mutations, commercial precision medicine treatments aren’t always available for patients with less common cancers. Clinical trials offer them a chance to still receive targeted treatments before the FDA approval process.
In addition to being offered access to treatment that is potentially more effective, patients who participate in clinical trials benefit from a more watchful eye. Each clinical trial patient is assigned a research nurse who tracks their progress. They’re also enrolled in a monitoring program called Chemo Care Companion, supported by donations to the Ochsner Excellence Fund and Cancer Institute. The program provides patients with medical devices—like blood pressure cuffs, scales and pulse oximeters—to monitor their vitals several times a day. These devices are wirelessly connected to the electronic medical record (EMR) system, so patient vitals are available in real time. “The integration of this information directly into the EMR so it’s instantly available to patients has been a tremendous advantage,” Dr. Brooks said.
Ochsner oncologists virtually meet for a system-wide precision medicine conference every week, and EMR records allow them to present the details of patients’ cases to their colleagues. Afterward, the entire practice generates a recommendation, which is also entered into the EMR. “That’s one of the great strengths of Ochsner,” Dr. Brooks added. “When you access one Ochsner location, you access the entire system.”
Advancing scientific research and standard of care
By participating in clinical trials, Ochsner patients play a part in a broader effort to find more effective treatments for a wide range of cancers. Patients diagnosed with metastatic melanoma with brain metastases, a particularly devastating disease, have seen their odds of survival transform. Ten years ago, life expectancy for the disease was just three months. Today, over 50 percent of patients are still alive years after starting immunotherapies. Many have completed their treatments with no signs of cancer.
“We’re curing a large number of these patients and giving them their lives back,” Dr. Matrana said. “That’s what clinical research is all about—finding a cure for this. In cases where we can’t find a cure, it totally changes the paradigm and allows patients to live longer, better lives. That’s why we do this work.“
PCTP has thrived for the past six years, enrolling hundreds of patients in treatment trials and thousands in testing trials. Thanks to corporate sponsorships and $3 million in philanthropic gifts over the years, Ochsner’s team can continue this lifesaving work.
“There are few places in this area of the United States that have the expertise, innovation and ability to persevere to develop these new and exciting programs for patients,” Dr. Brooks said. “They take time, money and effort.”
Despite the importance of the data collected through these trials and the potential breakthroughs in standard of care that lie ahead, Ochsner’s team doesn’t lose sight of its priority: patient care.
“The science and the new drugs that come out of this are extremely important, but the patient comes first,” Dr. Matrana said. “I ask myself, ‘What can I do for my patient that’s going to give them the best possible outcome?’ We think clinical trials are the way to go.”
