The importance of clinician access to clinical trial information for patient treatment

Clinical Expert Commentaries published on May 9, 2013 in Clinical Trials
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Robert Z. Orlowski, MD, PhD
Professor, Chair Ad Interim
Department of Lymphoma/Myeloma
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas

Thank you for joining me. My name is Robert Orlowski, I am a professor in the Department of Lymphoma/Myeloma as well as Experimental Therapeutics, and the director of the Myeloma Section at University of Texas MD Anderson Cancer Center. I wanted to talk to you a little bit today about the importance of accessing clinical trials for your patients. Myeloma patients have been doing much better over the current decade; in fact, we know that overall survival has doubled compared with previous decades. But still, we know that our upfront therapies do not resolve in complete remission in 100% of patients, and in the relapsed or refractory setting, although the options have increased, we still need more drugs to be able to get to the point where, again, 100% of patients are achieving a complete remission. This is where it is very important to try to include a discussion with your patients of the availability of clinical trials. There are a number of websites where you can access trials to look at what studies may be available in the local area. One of the best is where you can search based on disease as well as location, and if you have a particular drug in mind, you can search for that one as well, and those will have contact information for investigators at all of the centers. Just to give you some examples, right now in newly diagnosed multiple myeloma in the US Cooperative Group mechanism, there is a study which is comparing bortezomib with lenalidomide and dexamethasone to carfilzomib with lenalidomide and dexamethasone. This is an important study which will answer whether one proteasome inhibitor or another is better, and the chances are that no matter which arm patients are randomized to, they are going to have an excellent outcome. Another example is a study that is also occurring through the Intergroup mechanism which is targeting newly diagnosed patients with high-risk myeloma. These are patients who unfortunately, despite our best therapies, still have median overall survival of only three years, and that study is looking at incorporating elotuzumab, which is a monoclonal antibody, into the combination of lenalidomide with bortezomib and dexamethasone. Because elotuzumab is not yet FDA approved for any indication in myeloma, this is one of the few studies where you can have your patients have access to this drug. So the benefits of clinical trials are predominantly that patients will be able to be treated with new drugs that they otherwise would not have access to, and of course, in the longer term, the benefit is that if we enrolled more patients, we are able to complete the studies that are needed to optimize therapy for patients sooner. And I do believe that we already are curing at least some patients with myeloma by the definition of having a complete response at least 10 years or more after stem cell transplant, and I think that fraction is going to be improving with time, but we still need several new drugs to be approved for that to occur, and that is where clinical trials can be very important. So when you have patients, either in the newly diagnosed or relapsed or refractory settings, please do think about looking for clinical trial options and referring your patients to centers that may have these options available, or in many cases you yourself can participate in these trials and then have them available for your patients right there locally. Thanks very much for your consideration.

Reviewed on January 17, 2017 for clinical relevance.

Last modified: February 8, 2017
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