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Thanks for joining me to talk about clinical trials with regard to
malignant brain tumors.
Clinical trials of course, a source of hope for
people with this dire diagnosis.
When should someone think about a clinical trial?
>> Well, thank you for having me.
It's a very important question that you just asked.
Clinical trials often come into play when folks have completed
what's considered standard of care.
Meaning they've often had surgery, completed additional treatments,
often in the form of chemotherapy and or radiation therapy, but
unfortunately it appears that the tumor may be coming back.
Once standard of care has been completed,
then we can think about more experimental options.
Ie clinical trials which are designed to develop new therapies,
new treatments, with the hope of being able to better combat
the various brain tumors that we take care of.
>> How can someone find out about what range of clinical trials
are available?
That often is one of the challenges when dealing with clinical trials.
The biggest key to this is to maintain constant dialogue at
the time of diagnosis and throughout care with one's treating oncology
team members, radiation oncology, medical oncology, as well as
surgeons to see what options might be available if they were to arise.
In addition, there's a publically available database online that lists
all the clinical trials available in the United States currently,
that's clinicaltrials.gov, G-O-V.
And it's a fairly easy to navigate website, that is mandated by the US
government to list all clinical trials for the treatment of
malignant brain tumours as well as other diseases and
certainly something that's open to the public as well.
>> What are the risks that are involved in participating
in a clinical trial and if you were going to help a patient make
that decision, how would you weigh the risks and benefits?
>> Another very important question.
The first thing to understand is that really the vast majority
of studies that have looked at this have shown that patients with
malignant brain tumors, or other types of cancer that participate
in chemical trials, they do better than counterparts who don't.
So that's the first thing to understand,
is that clinical trials in general, even though we're testing
experimental therapies help patients to live longer and do better.
Part of that is because they get more intense care,
they're more closely monitored and this eventually helps patients, so
that's the first thing to understand.
In terms of the risks of clinical trials,
it really depends on what type of trial we're talking about.
Some trials have very minimal risks, things like fatigue, or
potential rash to very serious complications that can
occur depending on the type of treatment that's being employed.
And when I counsel my patients about this, we have a very
granular discussion about, what are the different options?
And go through each trial in detail in a systematic fashion to say,
these are the potential benefits, these are the potential risks.
And we learn as we go along with these clinical trials because
they're all still in their infancy in terms of the development.
>> Help me to understand how tumor genetics
could be important in treatment options.
>> So tumor genetics is basically our understanding of why these cells
that were previously normal became abnormal in cancers or tumours.
And the goal is to identify using understanding of this changes and
Achilles heel, ie a weakness in the tumour cell
that may not be present in normal cell.
And by understanding the tumor genetics,
we hope to be able to develop treatment support and
employ treatments that attack the Achilles heel
of that particular cancer or tumor that the individual's going through.
>> I know there's an awful lot of research going on out there but
what would you consider to be the cutting edge of research in clinical
trials for malignant brain tumors right now?
>> Well, there's a tremendous avalanche of incredible advances.
If I were to have to pick one treatment option that's increasingly
common in the clinical trial realm, it would be immunotherapy.
That is using one's own immune system to attack tumor cells.
There's a number of very,
very exciting protocols that do this in a multitude of ways.
Vaccine treatments, using viruses to ramp up the immune system,
using drugs to allow the immune cells to target tumor cells.
And this has been a treatment that's really gained a lot of attention,
cuz it's worked in a number of other non-brain tumor cancer types,
like lung cancer, melanoma, and others.
And we're very, very hopeful to see such dramatic results
when employed in brain tumors as well.
>> Sounds to me like you're pretty optimistic about the outlook.
>> Absolutely, never before have there been this many options and
this many good options for
individuals with malignant brain tumors.
While it is a very challenging diagnosis to hear,
it is certainly one that's filled with more hope now then ever before.
>> Great news, thanks so much.
>> Thank you for having me.
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