A cancer diagnosis can be life-changing, but doctors at leading cancer research centers in Arizona are optimistic about the future, thanks to rapid advancements in treatment.
Arizonans given this difficult diagnosis can find relief in having the option to choose from a list of renowned hospitals and cancer treatment centers close to home. Some of the best options include the Mayo Clinic Comprehensive Cancer Center, University of Arizona Cancer Center, and City of Hope, each of which totes their own accreditations and awards in the field.
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Oncologists at these institutions have the difficult task of fighting cancer with their patients day in and day out, but cancer treatment advancements, including precision medicine, clinical trials, and prevention methods, have lifted the spirits of everyone affected.
“We know that the only way to end cancer as we know it is by being innovative and bringing new treatments and therapeutic options to our patients,” says Dr. Rachna Shroff, associate director of clinical investigations at the University of Arizona Cancer Center.
The dynamic of cancer treatment advancements is fast-paced and competitive. Every year there are new advancements and updated treatments because everyone wants to contribute to the solution.
Most recently, the introduction of genomic cancer research and precision medicine in cancer treatment have caused a boost in morale, and an uptick in the number of cured cases of cancer.
“I’ve been involved in genomic cancer research for 13 or 14 years now and so this actually goes back to the early days when I started, most cancer doctors would say, ‘Oh, we’re never gonna do that. That doesn’t make any sense.’ And now everyone does it all the time and it’s not even a conversation,” says Dr. Alan Bryce, Chief Clinical Officer at City of Hope Cancer Center Phoenix.
Genomic cancer research is credited with sparking the cancer treatment advancements that led to precision medicine. The renowned Human Genome Project first mapped a genome sequence that accounted for over 90% of the human genome, also known as DNA, in 2003.
In the 20 years since human DNA was first mapped, scientists and researchers have leveraged that knowledge to make advancements in numerous fields, including cancer treatment. Precision medicine was born out of this information and doctors today are using genomic research to fine tune and perfect treatments all over the world.
When it comes to cancer, the National Cancer Institute states that precision medicine uses specific information about a patient’s tumor and body to help diagnose, plan, monitor, or determine the effectiveness of treatment. Genomic research has given doctors the additional information about the genetic mutations or variations in a patient’s tumor that might inform specific drug treatments.
Precision oncology has forced doctors to expand their idea of understanding a cancer patient. Rather than addressing only the broad cancer the patient was diagnosed with, practitioners now have more factors to take into consideration when tailoring the treatment to the patient. They can see where the cancer came from, whether it was genetics or environmental and target those specifics during treatment and even prevention.
“If you come to an infusion center and there are 10 women sitting there with breast cancer, although they all have breast cancer, they are all 10 different women and they all have 10 different breast cancers,” says Dr. Rick Bold, the Director of Mayo Clinic Comprehensive Cancer Center in Arizona. “So we would like any kind of treatment that is unique to them or their cancer, in a precise fashion, to give them the highest chance of being cured.”
With the ability to identify what a patient’s cancer treatment needs are based on lifestyle choices, genetics, and numerous other factors, doctors are excited by the results they have seen in curing cancers. Recognizing that each cancer is unique has brought on a wave of new clinical trials and new hope.
“If you have a specific mutation or gene alteration, and there’s a targeted treatment to go after that specific gene mutation and say lung cancer, for instance, where we do a lot of this, it’s really important to us that we bring the hottest and the latest drugs to our patients because we know that that is the way the puck is going. And so we want to stay ahead of the game,” says Shroff.
Going hand in hand with precision oncology, immunotherapy has had an equally important impact on the field.
Inside the body, cancer cells are foreign cells, doctors say these cells are relatively easy to identify, they look different, act different, and reproduce differently from the cells the body has naturally. While it is easy for a doctor to see the cancer in a patient’s body, it is not as easy for the individual’s built-in defense mechanism, the immune system, to identify and destroy these cancerous cells.
“Immunotherapy is a great advancement in which we are now achieving the ability to unmask cancer from a person’s own immune system,” says Bold.
With the help of immunotherapy, patients have seen positive results in their body’s ability to eradicate the cancer cells as it would bacteria or any other illness.
Immunotherapy, including treatments like checkpoint inhibitors, CAR-T cell therapy, and monoclonal antibodies, helps the immune system target and destroy cancer cells, often with fewer side effects than traditional chemotherapy.
Chemotherapy has been the go-to treatment for many cancers for almost a century. While it has been effective as a drug treatment for killing the fast-growing cancer cells it has also been known to destroy other cells the body needs to perform other essential functions. Due to the destruction of healthy cells, as well as cancer, chemotherapy also comes with a long list of unfavorable side effects including hair loss, flu like symptoms, and infection.
Immunotherapy has proven to be as effective as chemotherapy, while also allowing them to maintain their quality of life.
“I tell my patients all the time, yes, there are some rare, somewhat significant side effects from immunotherapy but they’re rare. By and large people’s quality of life on immunotherapy is just leaps and bounds different and better than some of the more historical approaches that we’ve used. So not only is it really helping us improve outcomes, improve survival, cure diseases, but it’s also doing it in a way that gives patients a meaningful quality of life throughout their treatment, which is really so just wonderful,” says Shroff.
As immunotherapy continues to advance, oncologists hope that someday it will be effective in treating more types of cancer. Currently immunotherapy is used to treat nearly two dozen different types of cancer, including brain cancer, breast cancer, and childhood cancer.
“The issue here though is even though we’re curing a lot of patients that we were not curing in 2010. We are absolutely curing cancers today that we were not curing in 2010 because of immunotherapy but there’s a lot more patients that are not cured yet. And so the question becomes, what about the cancers that we can’t cure yet with immunotherapy?” Says Bryce.
For more cancers to be cured, more trials have to be run. Clinical trials allow patients access to promising new treatments that are not yet widely available. By testing new drugs in real-world settings, these trials help researchers understand their effectiveness, side effects, and overall impact on survival rates.
Clinical trials are a staple of the cancer treatment conversation, we know from the basics of science that in order for something to be adopted as fact it has to be proven repeatedly. This same logic is behind clinical trials in oncology.
When researchers discover a drug’s ability to treat a certain type of cancer under the microscope or in animals the next step is to test its effectiveness in the human body. Clinical trials allow oncologists and researchers to prove a drug’s abilities and start the process of making it accessible for a larger patient pool.
Once a clinical trial drug is proven to be effective, safe and better than what was used prior to its discovery, it receives the FDA stamp of approval and can be widely distributed.
“That’s why trials have to continue because every single breakthrough we have in cancer, every single treatment a patient is getting has to come through the trials process at some point. And so if we stop doing research, if we stop doing trials, what we’re saying is where we are is good enough and of course, that’s not acceptable. None of us are happy with where we’re at right now because we have patients that are still dying. So, until we fix that, the answer is we have to continue doing research, we have to continue trialing drugs,” says Bryce.
Clinical trials are only possible because of the partnership between the biotech industry and medicine.
“The Phoenix market is really right to become that leading biotech incubator corridor through partnerships between academic medical centers like Mayo Clinic, undergraduate and really basic science research centers like ASU and then industry partners so we can accelerate the discovery of the groundbreaking cancer treatments. And then the important part is really to move it more quickly into manufacturing commercialization and have a broader impact than just the patients here in Arizona,” says Bold.
From the lab bench to the patient’s bedside, a drug must pass through numerous hands to land itself on the list of approved treatments. Collaboration between academic institutions and the biotech industry is crucial for accelerating breakthroughs in cancer treatment, allowing innovative discoveries to reach patients faster and have a broader impact.
Partnerships like the Mayo Clinic’s work with researchers at Arizona State University, University of Arizona Cancer Center’s relationship with the university’s engineering program, and City of Hope’s continued work with the Translational Genomics Research Institute are all examples of the collaboration required to make new discoveries.
“We’re absolutely stronger together than we are apart,” says Bryce.
As cancer treatment advancements like precision medicine and immunotherapy continue to evolve, doctors and researchers remain hopeful that more types of cancer will be curable in the near future, offering patients not just longer lives, but better quality of life as well.
